Prognostic value of three rapid scoring scales and combined predictors for the assessment of patients with coronavirus disease 2019.

ABSTRACT

AIM: To explore the factors affecting mortality in patients with COVID-19 and to verify the predictive value of the three rapid scoring scales MEWS, RAPS and REMS. DESIGN: Cross-sectional observational study. METHODS: Kaplan-Meier and Cox survival analyses were performed to identify the risk factors associated with COVID-19-related death. A ROC curve analysis was used to evaluate the abilities of the three scoring scales to predict the prognosis of COVID-19 patients. RESULTS: Age, low blood oxygen saturation level and decreased lymphocyte count were the high risk factors for COVID-19-related mortality. The analysis of the abilities of the three scales to predict the prognosis of COVID-19 patients The AUC of 0.641 for the RAPS (p = .065). The MEWS (AUC = 0.705, p = .007), compared with RAPS, the NRI was 0.371(p = .03), and the IDI = 0.092 (p = .046); The REMS (AUC = 0.841, p < .001), compared with MEWS, the NRI was 0.227(p = .12), and the IDI=0.09(p = .047); The Combining Predictor (AUC = 0.878, p < .001), compared with REMS, the NRI was 0.25(p = .113), and the IDI=0.02(p = .598). CONCLUSION: Patients with an old age, low blood oxygen saturation level and decreased lymphocyte count were at a high risk of COVID-19-related mortality. Moreover, our analysis revealed that the REMS had a better prognostic ability than the MEWS and RAPS when applied to COVID-19 patients. Our findings suggest that the REMS can be used as a rapid scoring tool for the early assessment of COVID-19 severity.