Yonsei Med J.  2021 Sep;62(9):806-813. 10.3349/ymj.2021.62.9.806.

New Scoring System for Predicting Mortality in Patients with COVID-19

• Bae S
• Kim Y
• Hwang S
• Kwon KT
• Chang HH
• Kim SW

• KMID: 2519358
• DOI: http://doi.org/10.3349/ymj.2021.62.9.806

Abstract

Purpose
We aimed to develop a novel mortality scoring system for inpatients with COVID-19 based on simple demographic factors and laboratory findings.
Materials and Methods
We reviewed and analyzed data from patients who were admitted and diagnosed with COVID-19 at 10 hospitals in Daegu, South Korea, between January and July 2020. We randomized and assigned patients to the development and validation groups at a 70% to 30% ratio. Each point scored for selected risk factors helped build a new mortality scoring system using Cox regression analysis. We evaluated the accuracy of the new scoring system in the development and validation groups using the area under the curve.
Results
The development group included 1232 patients, whereas the validation group included 528 patients. In the development group, predictors for the new scoring system as selected by Cox proportional hazards model were age ≥70 years, diabetes, chronic kidney disease, dementia, C-reactive protein levels >4 mg/dL, infiltration on chest X-rays at the initial diagnosis, and the need for oxygen support on admission. The areas under the curve for the development and validation groups were 0.914 [95% confidence interval (CI) 0.891–0.937] and 0.898 (95% CI 0.854–0.941), respectively. According to our scoring system, COVID-19 mortality was 0.4% for the low-risk group (score 0–3) and 53.7% for the very high-risk group (score ≥11).
Conclusion
We developed a new scoring system for quickly and easily predicting COVID-19 mortality using simple predictors. This scoring system can help physicians provide the proper therapy and strategy for each patient.

Keyword

COVID-19; mortality; scoring system