• Asim Ahmed, Sayed A Alderazi, Rumaisa Aslam, Barooq Barkat, Bethan L Barker, Rahul Bhat, Samuel Cassidy, Louise E Crowley, Davinder Ps Dosanjh, Hussain Ebrahim, Najla Elndari, Claudia Gardiner, Atena Gogokhia, Frances S Grudzinska, Megha T Gurung, Terry Hughes, Iyad Ismail, Natasha Iredale, Sannaan Irshad, Sarah Johnson, Diana Kavanagh, Thomas Knight, Alana Livesey, Sebastian T Lugg, Manoj Marathe, Andrew McDougall, Wasim Nawaz, Kimberly Nettleton, Lauren O'Flynn, Kelvin Okoth, Dhruv Parekh, Rita Perry, Elizabeth J Pudney, Ambreen Sadiq, Olutobi Soge, Rhania Soloman, Marina Soltan, Martin Strecker, Onn S Thein, David Thickett, Ajit Thomas, and Riah Thornton.
• Royal Stoke University Hospital, Stoke on Trent, UK.
• Clin Med (Lond). 2022 Jan 1; 22 (1): 637063-70.

BackgroundSeverity scores in pneumonia and sepsis are being applied to SARS-CoV-2 infection. We aimed to assess whether these severity scores are accurate predictors of early adverse outcomes in COVID-19.MethodsWe conducted a multicentre observational study of hospitalised SARS-CoV-2 infection. We assessed risk scores (CURB65, qSOFA, Lac-CURB65, MuLBSTA and NEWS2) in relation to admission to intensive care or death within 7 days of admission, defined as early severe adverse events (ESAE). The 4C Mortality Score was also assessed in a sub-cohort of patients.FindingsIn 2,387 participants, the overall mortality was 18%. In all scores examined, increasing score was associated with increased risk of ESAE. Area under the curve (AUC) to predict ESAE for CURB65, qSOFA, Lac-CURB65, MuLBSTA and NEWS2 were 0.61, 0.62, 0.59, 0.59 and 0.68, respectively. AUC to predict ESAE was 0.60 with ISARIC 4C Mortality Score.ConclusionNone of the scores examined accurately predicted ESAE in SARS-CoV-2 infection. Non-validated scores should not be used to inform clinical decision making in COVID-19.© Royal College of Physicians 2022. All rights reserved.

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