Performance of Risk Scores in SARS-CoV-2 Infection: A Retrospective Study

Prognostic scores that help allocate resources and time to the most critical patients could have potentially improved the response to the SARS-CoV-2 pandemic. We assessed the performance of five risk scores in predicting death or transfer to the intensive care unit (ICU) or sub-intensive care unit (SICU) in hospitalised patients with SARS-CoV-2 infection, with the three aims of retrospectively analysing the effectiveness of these tools, identifying frail patients at risk of death or complications due to infection, and applying these tools in the event of future pandemics. A retrospective observational study was conducted by evaluating data from patients hospitalised with SARS-CoV-2 infection. Among 134 patients considered, 119 were enrolled. All patients were adults, with a mean age of 64 years, and were hospitalised in the Infectious Diseases Division. We compared the five scores using receiver operating characteristic curves and calculation of the areas under the curve (AUCs) to determine their predictive performance. Four of the five scores demonstrated a high accuracy in predicting mortality among COVID-19-positive patients, with AUCs between 0.749 and 0.885. However, only two of the five scores showed good performance in predicting transfer to the ICU or SICU, with AUCs ranging from 0.740 to 0.802. The 4C Mortality Score and COVID-GRAM presented the highest performance for both outcomes. These two scores are easy to apply and low cost. They could still be used in clinical practice as predictive tools for frail and elderly patients with SARS-CoV-2 infection, as well as in the event of future pandemics.