The AIFELL Score as a Predictor of Coronavirus Disease 2019 (COVID-19) Severity and Progression in Hospitalized Patients.

Ian Levenfus,Jutta Rose,Melina Stüssi-Helbling,Katja Petrowski,Lars C. Huber,Enrico Ullmann,Macé M. Schuurmans

doi:10.3390/diagnostics12030604

Abstract

Since the beginning of the COVID-19 pandemic, SARS-CoV-2 has caused a global burden for health care systems due to high morbidity and mortality rates, leading to caseloads that episodically surpass hospital resources. Due to different disease manifestations, the triage of patients at high risk for a poor outcome continues to be a major challenge for clinicians. The AIFELL score was developed as a simple decision instrument for emergency rooms to distinguish COVID-19 patients in severe disease stages from less severe COVID-19 and non-COVID-19 cases. In the present study, we aimed to evaluate the AIFELL score as a prediction tool for clinical deterioration and disease severity in hospitalized COVID-19 patients. During the second wave of the COVID-19 pandemic in Switzerland, we analyzed consecutively hospitalized patients at the Triemli Hospital Zurich from the end of November 2020 until mid-February 2021. Statistical analyses were performed for group comparisons and to evaluate significance. AIFELL scores of patients developing severe COVID-19 stages IIb and III during hospitalization were significantly higher upon admission compared to those patients not surpassing stages I and IIa. Group comparisons indicated significantly different AIFELL scores between each stage. In conclusion, the AIFELL score at admission was useful to predict the disease severity and progression in hospitalized COVID-19 patients.

Highlights

Two years after coronavirus disease 2019 (COVID-19) became a worldwide pandemic, the causative agent named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)is still a considerable burden for the health care systems of many countries, leading to restrictions of personal movement and business, as well as travel, and sometimes even leading to lockdowns
Despite available vaccines and associated government-funded vaccination campaigns, the spread of SARS-CoV-2 has not been stopped yet and has resulted in recurrent waves of increasing infection rates, which have put a considerable strain on hospitals and, in particular, their intensive care units (ICU)
The score was retrospectively applied to consecutively hospitalized SARS-CoV-2positive patients from 22 November 2020 until 17 February 2021 that were treated at the City Hospital Zurich Triemli (Stadtspital Zürich Triemli) during the second wave of the COVID-19 pandemic in Switzerland

Summary

Introduction

Is still a considerable burden for the health care systems of many countries, leading to restrictions of personal movement and business, as well as travel, and sometimes even leading to lockdowns. Despite available vaccines and associated government-funded vaccination campaigns, the spread of SARS-CoV-2 has not been stopped yet and has resulted in recurrent waves of increasing infection rates, which have put a considerable strain on hospitals and, in particular, their intensive care units (ICU). Britain [9], have been jeopardized by an incomplete effectiveness of the available. Great Britain [9], have been jeopardized by an incomplete effectiveness of the available vaccines associated vaccine breakthroughs [7,10], decreasing neutralizing neutralizing antibody vaccines and and associated vaccine breakthroughs [7,10], decreasing antibody titers over time [11]. Different mutations of the SARS-CoV-2 spike protein occurred, leading to the emergence of new strains, including the Alpha, Beta, Gamma, Delta and Omicron variants [1,2], which were declared to be Diagnostics 2022, 12, 604 mutations of the SARS-CoV-2 spike protein occurred, leading to the emergence of new strains, including the Alpha, Beta, Gamma, Delta and Omicron variants [1,2], which were declared to be variants of concern (VOC) by the World Health Organization (WHO), as variants of concern (VOC) by the World Health Organization (WHO), as they are suspected they are suspected to cause increased virulence [1,3], higher hospitalization or mortality to cause increased virulence [1,3], higher hospitalization or mortality rates [4,5] or an rates [4,5] or an immune evasion [6,7].

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Conclusion