Predict Score: A New Biological and Clinical Tool to Help Predict Risk of Intensive Care Transfer for COVID-19 Patients.

Mickael Gette,Nicolas Bruder,Sara Fernandes,Julien Fromonot,Maelle Dambo,Marine Duranjou,Pierre Michelet,Regis Guieu,Wijayanto Adi,Pierre Simeone,Marion Marlinge

doi:10.3390/biomedicines9050566

Abstract

Background: The COVID-19 crisis has strained world health care systems. This study aimed to develop an innovative prediction score using clinical and biological parameters (PREDICT score) to anticipate the need of intensive care of COVID-19 patients already hospitalized in standard medical units. Methods: PREDICT score was based on a training cohort and a validation cohort retrospectively recruited in 2020 in the Marseille University Hospital. Multivariate analyses were performed, including clinical, and biological parameters, comparing a baseline group composed of COVID-19 patients exclusively treated in standard medical units to COVID-19 patients that needed intensive care during their hospitalization. Results: Independent variables included in the PREDICT score were: age, Body Mass Index, Respiratory Rate, oxygen saturation, C-reactive protein, neutrophil–lymphocyte ratio and lactate dehydrogenase. The PREDICT score was able to correctly identify more than 83% of patients that needed intensive care after at least 1 day of standard medical hospitalization. Conclusions: The PREDICT score is a powerful tool for anticipating the intensive care need for COVID-19 patients already hospitalized in a standard medical unit. It shows limitations for patients who immediately need intensive care, but it draws attention to patients who have an important risk of needing intensive care after at least one day of hospitalization.

Highlights

In December 2019, medical teams of Wuhan, Hubei, China discovered a novel coronavirus responsible for acute respiratory distress syndrome (ARDS)
Univariate analysis between Standard Medical Unit (SMU) vs. intensive care unit (ICU) groups and SMU vs. STol groups, identified that patients with ages inferior to 75 years were more likely to be admitted to ICU
This study shows the potential of this score to anticipate the risk of intensive care necessity for COVID-19 patients hospitalized in standard medical units

Summary

Introduction

In December 2019, medical teams of Wuhan, Hubei, China discovered a novel coronavirus responsible for acute respiratory distress syndrome (ARDS) They were able to identify this new pathogen using next-generation sequencing and transforming the real-time polymerase chain reaction (RT-PCR) in a “user-friendly” diagnostic tool for laboratories with little familiarity with this technology [1]. Conclusions: The PREDICT score is a powerful tool for anticipating the intensive care need for COVID-19 patients already hospitalized in a standard medical unit. It shows limitations for patients who immediately need intensive care, but it draws attention to patients who have an important risk of needing intensive care after at least one day of hospitalization

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