Novel Score for Prediction of Severity and Mortality in Hospitalized Patients with COVID-19

Skakun Oleksiy; Seredyuk Nestor

doi:doi:10.11648/j.ijidt.20230803.13

| Peer-Reviewed

Novel Score for Prediction of Severity and Mortality in Hospitalized Patients with COVID-19

Skakun Oleksiy, Seredyuk Nestor

Published in International Journal of Infectious Diseases and Therapy (Volume 8, Issue 3)

Received: 4 July 2023 Accepted: 18 July 2023 Published: 27 July 2023

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Abstract

Background: Despite the presence of many scores for the prediction of severity and mortality in COVID-19 patients, predictive accuracies of them are not high enough. Aim: Development of a scale for the prediction of severe condition and in-hospital mortality in hospitalized patients with COVID-19-associated pneumonia. Methods: The study included 135 adult patients hospitalized for COVID-19-associated pneumonia. Risk factors and optimal cut-off criteria for severe/critical condition and in-hospital mortality was established. Results: body mass index (BMI), scales CURB-65 and PSI, history of diabetes mellitus, SpO₂ level at admission, leukocyte count, lymphocyte percentage, levels of fasting glucose, alanine aminotransferase, ferritin, soluble IL-2 receptors, IL-6, and ferritin-hemoglobin ratio (FHR) were risk factors for disease progression to severe/critical condition. Logistic regression showed that only SpO₂, creatinine, and blood urea nitrogen were independent risk factors of severe/critical condition. Risk factors for in-hospital mortality included age, BMI, scales CURB-65 and PSI, SpO₂ level at admission, hemoglobin level, leukocyte count, levels of fasting glucose, creatinine, blood urea nitrogen, ferritin, IL-6, and FHR. However, logistic regression showed no relevant independent risk factor of in-hospital mortality. The novel score has been developed; it included the following parameters: blood pressure, BMI, ferritin level, SpO₂, creatinine level, history of arterial hypertension/ prior myocardial infarction / stroke, leukocyte count, elderly, history of diabetes mellitus (acronym “BIFOCALED”). There was good discriminative power of the novel score for severe/critical condition (AUC, 0.806, p<0.001) and in-hospital mortality (AUC, 0.804, p<0.001). The Youden index was 0.47 at the value of >2 points (sensitivity of 84.72%; specificity of 61.90%) for the prediction of severe/critical condition and 0.58 at the value of >5 points (sensitivity of 64.29%; specificity of 93.39%) for prediction of in-hospital mortality. Patients who scored >2 points had a far much higher risk of severe/critical condition (OR, 9.01; 95%CI, 3.97–20.44; p<0.001). In-hospital mortality was significantly higher in patients with >5 points according to the novel score (OR, 25.43; 95%CI, 6.88–93.99; p<0.001). Also, the probability of severe/critical condition and in-hospital mortality depending on the novel score was assessed. Conclusion: The BIFOCALED score may be used for predicting severe/critical condition and in-hospital mortality. The disease progression to severe/critical condition should be suspected in patients who scored >2 points; however, a score of >5 points is associated with high in-hospital mortality.

Published in	International Journal of Infectious Diseases and Therapy (Volume 8, Issue 3)
DOI	10.11648/j.ijidt.20230803.13
Page(s)	91-100
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

COVID-19, Score, BIFOCALED, Severity, Mortality

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Skakun Oleksiy, Seredyuk Nestor. (2023). Novel Score for Prediction of Severity and Mortality in Hospitalized Patients with COVID-19. International Journal of Infectious Diseases and Therapy, 8(3), 91-100. https://doi.org/10.11648/j.ijidt.20230803.13

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ACS Style

Skakun Oleksiy; Seredyuk Nestor. Novel Score for Prediction of Severity and Mortality in Hospitalized Patients with COVID-19. Int. J. Infect. Dis. Ther. 2023, 8(3), 91-100. doi: 10.11648/j.ijidt.20230803.13

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AMA Style

Skakun Oleksiy, Seredyuk Nestor. Novel Score for Prediction of Severity and Mortality in Hospitalized Patients with COVID-19. Int J Infect Dis Ther. 2023;8(3):91-100. doi: 10.11648/j.ijidt.20230803.13

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@article{10.11648/j.ijidt.20230803.13,
  author = {Skakun Oleksiy and Seredyuk Nestor},
  title = {Novel Score for Prediction of Severity and Mortality in Hospitalized Patients with COVID-19},
  journal = {International Journal of Infectious Diseases and Therapy},
  volume = {8},
  number = {3},
  pages = {91-100},
  doi = {10.11648/j.ijidt.20230803.13},
  url = {https://doi.org/10.11648/j.ijidt.20230803.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20230803.13},
  abstract = {Background: Despite the presence of many scores for the prediction of severity and mortality in COVID-19 patients, predictive accuracies of them are not high enough. Aim: Development of a scale for the prediction of severe condition and in-hospital mortality in hospitalized patients with COVID-19-associated pneumonia. Methods: The study included 135 adult patients hospitalized for COVID-19-associated pneumonia. Risk factors and optimal cut-off criteria for severe/critical condition and in-hospital mortality was established. Results: body mass index (BMI), scales CURB-65 and PSI, history of diabetes mellitus, SpO2 level at admission, leukocyte count, lymphocyte percentage, levels of fasting glucose, alanine aminotransferase, ferritin, soluble IL-2 receptors, IL-6, and ferritin-hemoglobin ratio (FHR) were risk factors for disease progression to severe/critical condition. Logistic regression showed that only SpO2, creatinine, and blood urea nitrogen were independent risk factors of severe/critical condition. Risk factors for in-hospital mortality included age, BMI, scales CURB-65 and PSI, SpO2 level at admission, hemoglobin level, leukocyte count, levels of fasting glucose, creatinine, blood urea nitrogen, ferritin, IL-6, and FHR. However, logistic regression showed no relevant independent risk factor of in-hospital mortality. The novel score has been developed; it included the following parameters: blood pressure, BMI, ferritin level, SpO2, creatinine level, history of arterial hypertension/ prior myocardial infarction / stroke, leukocyte count, elderly, history of diabetes mellitus (acronym “BIFOCALED”). There was good discriminative power of the novel score for severe/critical condition (AUC, 0.806, p2 points (sensitivity of 84.72%; specificity of 61.90%) for the prediction of severe/critical condition and 0.58 at the value of >5 points (sensitivity of 64.29%; specificity of 93.39%) for prediction of in-hospital mortality. Patients who scored >2 points had a far much higher risk of severe/critical condition (OR, 9.01; 95%CI, 3.97–20.44; p5 points according to the novel score (OR, 25.43; 95%CI, 6.88–93.99; p2 points; however, a score of >5 points is associated with high in-hospital mortality.},
 year = {2023}
}

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TY  - JOUR
T1  - Novel Score for Prediction of Severity and Mortality in Hospitalized Patients with COVID-19
AU  - Skakun Oleksiy
AU  - Seredyuk Nestor
Y1  - 2023/07/27
PY  - 2023
N1  - https://doi.org/10.11648/j.ijidt.20230803.13
DO  - 10.11648/j.ijidt.20230803.13
T2  - International Journal of Infectious Diseases and Therapy
JF  - International Journal of Infectious Diseases and Therapy
JO  - International Journal of Infectious Diseases and Therapy
SP  - 91
EP  - 100
PB  - Science Publishing Group
SN  - 2578-966X
UR  - https://doi.org/10.11648/j.ijidt.20230803.13
AB  - Background: Despite the presence of many scores for the prediction of severity and mortality in COVID-19 patients, predictive accuracies of them are not high enough. Aim: Development of a scale for the prediction of severe condition and in-hospital mortality in hospitalized patients with COVID-19-associated pneumonia. Methods: The study included 135 adult patients hospitalized for COVID-19-associated pneumonia. Risk factors and optimal cut-off criteria for severe/critical condition and in-hospital mortality was established. Results: body mass index (BMI), scales CURB-65 and PSI, history of diabetes mellitus, SpO2 level at admission, leukocyte count, lymphocyte percentage, levels of fasting glucose, alanine aminotransferase, ferritin, soluble IL-2 receptors, IL-6, and ferritin-hemoglobin ratio (FHR) were risk factors for disease progression to severe/critical condition. Logistic regression showed that only SpO2, creatinine, and blood urea nitrogen were independent risk factors of severe/critical condition. Risk factors for in-hospital mortality included age, BMI, scales CURB-65 and PSI, SpO2 level at admission, hemoglobin level, leukocyte count, levels of fasting glucose, creatinine, blood urea nitrogen, ferritin, IL-6, and FHR. However, logistic regression showed no relevant independent risk factor of in-hospital mortality. The novel score has been developed; it included the following parameters: blood pressure, BMI, ferritin level, SpO2, creatinine level, history of arterial hypertension/ prior myocardial infarction / stroke, leukocyte count, elderly, history of diabetes mellitus (acronym “BIFOCALED”). There was good discriminative power of the novel score for severe/critical condition (AUC, 0.806, p2 points (sensitivity of 84.72%; specificity of 61.90%) for the prediction of severe/critical condition and 0.58 at the value of >5 points (sensitivity of 64.29%; specificity of 93.39%) for prediction of in-hospital mortality. Patients who scored >2 points had a far much higher risk of severe/critical condition (OR, 9.01; 95%CI, 3.97–20.44; p5 points according to the novel score (OR, 25.43; 95%CI, 6.88–93.99; p2 points; however, a score of >5 points is associated with high in-hospital mortality.
VL  - 8
IS  - 3
ER  -

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Author Information

Skakun Oleksiy

Department of Internal Medicine No. 2 and Nursing, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
Seredyuk Nestor

Department of Internal Medicine No. 2 and Nursing, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine

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Plain Text BibTeX RIS

APA Style

Skakun Oleksiy, Seredyuk Nestor. (2023). Novel Score for Prediction of Severity and Mortality in Hospitalized Patients with COVID-19. International Journal of Infectious Diseases and Therapy, 8(3), 91-100. https://doi.org/10.11648/j.ijidt.20230803.13

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ACS Style

Skakun Oleksiy; Seredyuk Nestor. Novel Score for Prediction of Severity and Mortality in Hospitalized Patients with COVID-19. Int. J. Infect. Dis. Ther. 2023, 8(3), 91-100. doi: 10.11648/j.ijidt.20230803.13

Copy | Download

AMA Style

Skakun Oleksiy, Seredyuk Nestor. Novel Score for Prediction of Severity and Mortality in Hospitalized Patients with COVID-19. Int J Infect Dis Ther. 2023;8(3):91-100. doi: 10.11648/j.ijidt.20230803.13

Copy | Download

@article{10.11648/j.ijidt.20230803.13,
  author = {Skakun Oleksiy and Seredyuk Nestor},
  title = {Novel Score for Prediction of Severity and Mortality in Hospitalized Patients with COVID-19},
  journal = {International Journal of Infectious Diseases and Therapy},
  volume = {8},
  number = {3},
  pages = {91-100},
  doi = {10.11648/j.ijidt.20230803.13},
  url = {https://doi.org/10.11648/j.ijidt.20230803.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20230803.13},
  abstract = {Background: Despite the presence of many scores for the prediction of severity and mortality in COVID-19 patients, predictive accuracies of them are not high enough. Aim: Development of a scale for the prediction of severe condition and in-hospital mortality in hospitalized patients with COVID-19-associated pneumonia. Methods: The study included 135 adult patients hospitalized for COVID-19-associated pneumonia. Risk factors and optimal cut-off criteria for severe/critical condition and in-hospital mortality was established. Results: body mass index (BMI), scales CURB-65 and PSI, history of diabetes mellitus, SpO2 level at admission, leukocyte count, lymphocyte percentage, levels of fasting glucose, alanine aminotransferase, ferritin, soluble IL-2 receptors, IL-6, and ferritin-hemoglobin ratio (FHR) were risk factors for disease progression to severe/critical condition. Logistic regression showed that only SpO2, creatinine, and blood urea nitrogen were independent risk factors of severe/critical condition. Risk factors for in-hospital mortality included age, BMI, scales CURB-65 and PSI, SpO2 level at admission, hemoglobin level, leukocyte count, levels of fasting glucose, creatinine, blood urea nitrogen, ferritin, IL-6, and FHR. However, logistic regression showed no relevant independent risk factor of in-hospital mortality. The novel score has been developed; it included the following parameters: blood pressure, BMI, ferritin level, SpO2, creatinine level, history of arterial hypertension/ prior myocardial infarction / stroke, leukocyte count, elderly, history of diabetes mellitus (acronym “BIFOCALED”). There was good discriminative power of the novel score for severe/critical condition (AUC, 0.806, p2 points (sensitivity of 84.72%; specificity of 61.90%) for the prediction of severe/critical condition and 0.58 at the value of >5 points (sensitivity of 64.29%; specificity of 93.39%) for prediction of in-hospital mortality. Patients who scored >2 points had a far much higher risk of severe/critical condition (OR, 9.01; 95%CI, 3.97–20.44; p5 points according to the novel score (OR, 25.43; 95%CI, 6.88–93.99; p2 points; however, a score of >5 points is associated with high in-hospital mortality.},
 year = {2023}
}

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TY  - JOUR
T1  - Novel Score for Prediction of Severity and Mortality in Hospitalized Patients with COVID-19
AU  - Skakun Oleksiy
AU  - Seredyuk Nestor
Y1  - 2023/07/27
PY  - 2023
N1  - https://doi.org/10.11648/j.ijidt.20230803.13
DO  - 10.11648/j.ijidt.20230803.13
T2  - International Journal of Infectious Diseases and Therapy
JF  - International Journal of Infectious Diseases and Therapy
JO  - International Journal of Infectious Diseases and Therapy
SP  - 91
EP  - 100
PB  - Science Publishing Group
SN  - 2578-966X
UR  - https://doi.org/10.11648/j.ijidt.20230803.13
AB  - Background: Despite the presence of many scores for the prediction of severity and mortality in COVID-19 patients, predictive accuracies of them are not high enough. Aim: Development of a scale for the prediction of severe condition and in-hospital mortality in hospitalized patients with COVID-19-associated pneumonia. Methods: The study included 135 adult patients hospitalized for COVID-19-associated pneumonia. Risk factors and optimal cut-off criteria for severe/critical condition and in-hospital mortality was established. Results: body mass index (BMI), scales CURB-65 and PSI, history of diabetes mellitus, SpO2 level at admission, leukocyte count, lymphocyte percentage, levels of fasting glucose, alanine aminotransferase, ferritin, soluble IL-2 receptors, IL-6, and ferritin-hemoglobin ratio (FHR) were risk factors for disease progression to severe/critical condition. Logistic regression showed that only SpO2, creatinine, and blood urea nitrogen were independent risk factors of severe/critical condition. Risk factors for in-hospital mortality included age, BMI, scales CURB-65 and PSI, SpO2 level at admission, hemoglobin level, leukocyte count, levels of fasting glucose, creatinine, blood urea nitrogen, ferritin, IL-6, and FHR. However, logistic regression showed no relevant independent risk factor of in-hospital mortality. The novel score has been developed; it included the following parameters: blood pressure, BMI, ferritin level, SpO2, creatinine level, history of arterial hypertension/ prior myocardial infarction / stroke, leukocyte count, elderly, history of diabetes mellitus (acronym “BIFOCALED”). There was good discriminative power of the novel score for severe/critical condition (AUC, 0.806, p2 points (sensitivity of 84.72%; specificity of 61.90%) for the prediction of severe/critical condition and 0.58 at the value of >5 points (sensitivity of 64.29%; specificity of 93.39%) for prediction of in-hospital mortality. Patients who scored >2 points had a far much higher risk of severe/critical condition (OR, 9.01; 95%CI, 3.97–20.44; p5 points according to the novel score (OR, 25.43; 95%CI, 6.88–93.99; p2 points; however, a score of >5 points is associated with high in-hospital mortality.
VL  - 8
IS  - 3
ER  -

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