Prognostic Value of Physiological Scoring Systems in COVID-19 Patients: A Prospective Observational Study

The objective of this study was to investigate the accuracy of the Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), Rapid Acute Physiology Score (RAPS), Worthing Physiological Scoring System (WPSS), and Revised Trauma Score (RTS) for predicting the inhospital mortality of COVID-19 patients. This diagnostic accuracy study was conducted in Tehran, Iran, from November 15, 2020, to March 10, 2021. The participants consisted of 246 confirmed cases of COVID-19 patients who were admitted to the emergency department. The patients were followed from the point of admission up until discharge from the hospital. The mortality status of patients (survivor or nonsurvivor) was reported at the discharge time, and the receiver operating characteristic curve analysis of each scoring system for predicting inhospital mortality was estimated. The area under the curve of REMS was significantly higher than other scoring systems and in cutoff value of 6 and greater had a sensitivity and specificity of 89.13% and 55.50%, respectively. Among the five scoring systems employed in this study, REMS had the best accuracy to predict the inhospital mortality rate of COVID-19 patients and RAPS had the lowest accuracy for inhospital mortality. Thus, REMS is a useful tool that can be employed in identifying high-risk COVID-19 patients.