Prognostic risk scores for hospitalized COVID-19 patients during the omicron period

Öz

Aim: During the COVID-19 pandemic, as the number of cases and deaths increased various algorithms were started to used to facilitate patient management. This study aimed to assess the usefulness of the CALL, CHOSEN, HA2T2, and ANDC scores in prognostic assessment and to investigate the establishment of a new scoring system, referred to as CoNTroLAC. Materials and methods: We retrospectively analyzed hospitalized COVID-19 patients. Demographic and laboratory parameters, including comorbidity status, neutrophil-to-lymphocyte ratio (NLR), troponin, LDH, age, and CRP, were assessed in relation to mortality. Mortality distributions across CALL, HA₂T₂, and ANDC risk groups were compared with original reports. A new prognostic score, CoNTroLAC, was constructed using six admission-based parameters using ROC analysis. Results: Mortality was significantly associated with comorbidities, high NLR, elevated troponin, increased LDH, older age, and CRP >10 µg/mL. CALL, HA₂T₂, and ANDC scores demonstrated mortality stratification consistent with findings in their original cohorts. CoNTroLAC, integrating these six parameters, achieved excellent prognostic performance with an AUROC of 0.915. A cut-off score of 12.5 yielded 82.9% sensitivity and 84.7% specificity. Conclusion: In our Omicron-era cohort, CALL, HA₂T₂, and ANDC scores retained prognostic validity comparable to their original derivation studies. The newly developed CoNTroLAC score, incorporating comorbidity, NLR, troponin, LDH, age, and CRP, demonstrated excellent discrimination and may provide a simple, practical tool for early mortality risk stratification in hospitalized COVID-19 patients.

Anahtar Kelimeler

• COVID-19
• prognostic scores
• intensive care unit
• mortality

Omikron Döneminde Hastanede Yatan COVID-19 Hastaları İçin Prognostik Risk Puanları

Öz

Amaç: COVID-19 pandemisi sırasında, vaka ve ölüm sayıları arttıkça hasta yönetimini kolaylaştırmak için çeşitli algoritmalar kullanılmaya başlandı. Bu çalışmanın amacı, CALL, CHOSEN, HA2T2 ve ANDC puanlarının prognostik değerlendirmedeki yararlılığını değerlendirmek ve CoNTroLAC olarak adlandırılan yeni bir puanlama sisteminin oluşturulmasını araştırmaktır. Gereç ve Yöntemler: Hastanede yatan COVID-19 hastalarını retrospektif olarak analiz ettik. Eşlik eden hastalık durumu, nötrofil/lenfosit oranı (NLR), troponin, LDH, yaş ve CRP gibi demografik ve laboratuvar parametreleri mortalite ile ilişkili olarak değerlendirildi. CALL, HA₂T₂ ve ANDC risk gruplarındaki mortalite dağılımları orijinal raporlarla karşılaştırıldı. Altı yatış bazlı parametre kullanılarak ROC analizi kullanılarak yeni bir prognostik skor olan CoNTroLAC oluşturuldu. Bulgular: Mortalite, eşlik eden hastalıklar, yüksek NLR, yüksek troponin, artmış LDH, ileri yaş ve >10 µg/mL CRP ile anlamlı şekilde ilişkiliydi. CALL, HA₂T₂ ve ANDC skorları, orijinal kohortlarındaki bulgularla tutarlı bir mortalite sınıflandırması gösterdi. Bu altı parametreyi entegre eden CoNTroLAC, 0,915'lik bir AUROC ile mükemmel bir prognostik performans elde etti. 12,5'lik bir kesme puanı %82,9 duyarlılık ve %84,7 özgüllük sağladı. Sonuç: Omicron dönemi kohortumuzda, CALL, HA₂T₂ ve ANDC skorları, orijinal türetme çalışmalarına benzer prognostik geçerliliğini korudu. Eşlik eden hastalık, NLR, troponin, LDH, yaş ve CRP'yi içeren yeni geliştirilen CoNTroLAC skoru, mükemmel bir ayrımcılık göstermiştir ve hastaneye yatırılan COVID-19 hastalarında erken mortalite risk sınıflandırması için basit ve pratik bir araç sağlayabilir.

Anahtar Kelimeler

• COVID-19
• prognostik skorlar
• yoğun bakım ünitesi
• mortalite

Kaynakça

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