WHO Ordinal Scale and Inflammation Risk Categories in COVID-19

Background: The WHO ordinal severity scale has been used to predict mortality and guide trials in COVID-19. However, it has its limitations. Objective The present study aims to compare three classificatory and predictive models: the WHO ordinal severity scale, the model based on inflammation grades,...

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Detalles Bibliográficos
Autores: Rubio-Rivas, Manuel, Mora Luján, José María, Formiga Pérez, Francesc, Arévalo-Cañas, Coral, Lebrón Ramos, Juan Manuel, Villalba García, María Victoria, Fonseca Aizpuru, Eva Maria, Díez Manglano, Jesús, Arnalich Fernández, Francisco, Romero Cabrera, Juan Luis, García García, Gema María, Pesqueira Fontán, Paula María, Vargas Núñez, Juan Antonio, Freire Castro, Santiago Jesús, Loureiro Amigo, José, Pascual Pérez, Maria de los Reyes, Alcalá Pedrajas, José Nicolás, Encinas-Sánchez, Daniel, Mella Pérez, Carmen, Ena, Javier, Gracia Gutiérrez, Anyuli, Esteban Giner, María José, Varona, José F., Millán Núñez-Cortés, Jesús, Casas-Rojo, José Manuel
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/186772
Acceso en línea:https://hdl.handle.net/2445/186772
Access Level:acceso abierto
Palabra clave:COVID-19
Pronòstic mèdic
Inflamació
Mortalitat
Prognosis
Inflammation
Mortality
Descripción
Sumario:Background: The WHO ordinal severity scale has been used to predict mortality and guide trials in COVID-19. However, it has its limitations. Objective The present study aims to compare three classificatory and predictive models: the WHO ordinal severity scale, the model based on inflammation grades, and the hybrid model. Design Retrospective cohort study with patient data collected and followed up from March 1, 2020, to May 1, 2021, from the nationwide SEMI-COVID-19 Registry. The primary study outcome was in-hospital mortality. As this was a hospital-based study, the patients included corresponded to categories 3 to 7 of the WHO ordinal scale. Categories 6 and 7 were grouped in the same category. Key Results A total of 17,225 patients were included in the study. Patients classified as high risk in each of the WHO categories according to the degree of inflammation were as follows: 63.8% vs. 79.9% vs. 90.2% vs. 95.1% (p<0.001). In-hospital mortality for WHO ordinal scale categories 3 to 6/7 was as follows: 0.8% vs. 24.3% vs. 45.3% vs. 34% (p<0.001). In-hospital mortality for the combined categories of ordinal scale 3a to 5b was as follows: 0.4% vs. 1.1% vs. 11.2% vs. 27.5% vs. 35.5% vs. 41.1% (p<0.001). The predictive regression model for in-hospital mortality with our proposed combined ordinal scale reached an AUC=0.871, superior to the two models separately. Conclusions The present study proposes a new severity grading scale for COVID-19 hospitalized patients. In our opinion, it is the most informative, representative, and predictive scale in COVID-19 patients to date.

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