Comparison of COVID-GRAM, 4C Mortality, qSOFA, SIRS, NEWS, and MEWS in Predicting Mortality in COVID-19

Abstract

Objective: Mortality prediction methods are still controversial about coronavirus disease-2019 (COVID-19) pneumonia. This study aimed to compare the efficacy of the the quick Sequential Organ Failure Assessment, systemic inflammatory response syndrome (SIRS), Modified Early Warning score (MEWS), National Early Warning score, 4C mortality, and COVID-GRAM critical illness risk score (COVID-GRAM), scoring systems in predicting 28-day mortality in adult patients with COVID-19.Methods: This single-center, retrospective, observational cohort study included patients presenting to a pandemic hospital between November 2021 and December 2021. Inclusion criteria were patients aged 18 years or older, patients with positive reverse transcription-polymerase chain reaction test, and thoracic computed tomography imaging. The receiver operating characteristic analysis was performed to examine the diagnostic accuracy of the investigated scoring systems in predicting 28-day mortality. Statistical analyses were performed using the SPSS and MedCalc software packages. A p-value of <0.5 was considered statistically significant.Results: The study was conducted in 846 patients. The median age of the patients included in the study was 49 (36-75) years, and the rate of male patients was 46.3% (n=392). The rate of pneumonia detection was 85.1% (n=720). The hospitalization rate was 49.6% (n=420), the admission rate to the intensive care unit was 7.4% (n=63), and the 28-day mortality rate was 5.7% (n=48). The highest area under the curve (AUC) values for 28-day mortality prediction was obtained from COVID-GRAM (AUC: 0.935) and 4C mortality (AUC: 0.922) scores, while the lowest AUC values were calculated in SIRS (AUC: 0.756) and MEWS (AUC: 0.805).Conclusion: According to our results, COVID-GRAM may be the first-choice scoring system in the emergency department for predicting the 28-day mortality associated with COVID-19.