Utility of clinico-hematological risk assessment and severity score (chase score) in covid-19 patients

Abstract

Treating COVID-19 during pandemic situations is a challenge to utilize the resources judiciously. A proper triage and prognostication are very helpful. We aim to formulate a combined clinico-hematological scoring system in COVID – 19 patients and check its utility in prognostication in terms of mortality and development of complications in COVID-19 patients. This retrospective cross-sectional study included patients that were admitted to CDSIMER for treatment. Demographic, clinical, laboratory and outcome data were extracted from the respective patient files stored at medical records department. We formed a clinico hematological scoring system that included 8 parameters and each parameter was scored as 1 or 2. Based on total score (range 8 to 16) obtained they were categorized into low risk and high risk for treatment outcomes.We studied data of 451 COVID-19 patients admitted in CDSIMER from April 2021 to July 2021. We observed 100% recovery in the patients with score 8, 9 and 10. The mortality began to appear from score 11 onwards, showing increasing trend of mortality with higher scores. Therefore, score of ≥ 11 was established as the cut off to determine high risk for mortality. Out of the total 451 COVID patients, 70.10% (n=316 cases) came under the high-risk category, out of which 13.60% (n=43) had mortality and despite high risk as many as 86.40% patients (n=273) recovered with or without complications. Low risk category had demonstrated 100% (n=351) recovered cases. The p value was significant (0.00) on comparing the outcomes in the two categories of the proposed scoring system. Chase score is a novel scoring system easy and feasible to use in any hospital setting. The score helps clinicians to triage patients at admission to determine the standard of care, the need to carry out selective follow up investigations but not compromising in implementing the standard of care. Future prospective studies which can measure the internal and external validity of the score is very important.