• J Am Board Fam Med · Feb 2021

    Multicenter Study

    Development and Validation of the COVID-NoLab and COVID-SimpleLab Risk Scores for Prognosis in 6 US Health Systems.

    • Mark H Ebell, Xinyan Cai, Robert Lennon, Derjung M Tarn, Arch G Mainous, Aleksandra E Zgierska, Bruce Barrett, Wen-Jan Tuan, Kevin Maloy, Munish Goyal, and Alex Krist.
    • From the Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens (MHE, XC); Department of Family and Community Medicine, Penn State College of Medicine, Hershey (RL); Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles (DMT); Department of Health Services Research, Management and Policy, University of Florida, Gainesville (AGM); Departments of Public Health Sciences, and Anesthesiology and Perioperative Medicine, Penn State College of Medicine, Hershey (AEZ); Department of Family Medicine and Community Health, University of Wisconsin, Madison (BB, WJT); Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC (KM, MG); Department of Family Medicine, Virginia Commonwealth University, Richmond (AK). ebell@uga.edu.
    • J Am Board Fam Med. 2021 Feb 1; 34 (Suppl): S127-S135.

    PurposeDevelop and validate simple risk scores based on initial clinical data and no or minimal laboratory testing to predict mortality in hospitalized adults with COVID-19.MethodsWe gathered clinical and initial laboratory variables on consecutive inpatients with COVID-19 who had either died or been discharged alive at 6 US health centers. Logistic regression was used to develop a predictive model using no laboratory values (COVID-NoLab) and one adding tests available in many outpatient settings (COVID-SimpleLab). The models were converted to point scores and their accuracy evaluated in an internal validation group.ResultsWe identified 1340 adult inpatients with complete data for nonlaboratory parameters and 741 with complete data for white blood cell (WBC) count, differential, c-reactive protein (CRP), and serum creatinine. The COVID-NoLab risk score includes age, respiratory rate, and oxygen saturation and identified risk groups with 0.8%, 11.4%, and 40.4% mortality in the validation group (AUROCC = 0.803). The COVID-SimpleLab score includes age, respiratory rate, oxygen saturation, WBC, CRP, serum creatinine, and comorbid asthma and identified risk groups with 1.0%, 9.1%, and 29.3% mortality in the validation group (AUROCC = 0.833).ConclusionsBecause they use simple, readily available predictors, developed risk scores have potential applicability in the outpatient setting but require prospective validation before use.© Copyright 2021 by the American Board of Family Medicine.

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