WHO Ordinal Scale and Inflammation Risk Categories in COVID-19

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

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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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

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spelling	WHO Ordinal Scale and Inflammation Risk Categories in COVID-19Rubio-Rivas, ManuelMora Luján, José MaríaFormiga Pérez, FrancescArévalo-Cañas, CoralLebrón Ramos, Juan ManuelVillalba García, María VictoriaFonseca Aizpuru, Eva MariaDíez Manglano, JesúsArnalich Fernández, FranciscoRomero Cabrera, Juan LuisGarcía García, Gema MaríaPesqueira Fontán, Paula MaríaVargas Núñez, Juan AntonioFreire Castro, Santiago JesúsLoureiro Amigo, JoséPascual Pérez, Maria de los ReyesAlcalá Pedrajas, José NicolásEncinas-Sánchez, DanielMella Pérez, CarmenEna, JavierGracia Gutiérrez, AnyuliEsteban Giner, María JoséVarona, José F.Millán Núñez-Cortés, JesúsCasas-Rojo, José ManuelCOVID-19Pronòstic mèdicInflamacióMortalitatCOVID-19PrognosisInflammationMortalityBackground: 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.Springer Nature2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/186772Articles publicats en revistes (Ciències Clíniques)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1007/s11606-022-07511-7Journal of General Internal Medicine, 2022https://doi.org/10.1007/s11606-022-07511-7cc by-nc-nd (c) Rubio-Rivas, Manuel et al., 2022https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1867722026-05-27T06:46:51Z
dc.title.none.fl_str_mv	WHO Ordinal Scale and Inflammation Risk Categories in COVID-19
title	WHO Ordinal Scale and Inflammation Risk Categories in COVID-19
spellingShingle	WHO Ordinal Scale and Inflammation Risk Categories in COVID-19 Rubio-Rivas, Manuel COVID-19 Pronòstic mèdic Inflamació Mortalitat COVID-19 Prognosis Inflammation Mortality
title_short	WHO Ordinal Scale and Inflammation Risk Categories in COVID-19
title_full	WHO Ordinal Scale and Inflammation Risk Categories in COVID-19
title_fullStr	WHO Ordinal Scale and Inflammation Risk Categories in COVID-19
title_full_unstemmed	WHO Ordinal Scale and Inflammation Risk Categories in COVID-19
title_sort	WHO Ordinal Scale and Inflammation Risk Categories in COVID-19
dc.creator.none.fl_str_mv	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
author	Rubio-Rivas, Manuel
author_facet	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
author_role	author
author2	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
author2_role	author author author author author author author author author author author author author author author author author author author author author author author author
dc.subject.none.fl_str_mv	COVID-19 Pronòstic mèdic Inflamació Mortalitat COVID-19 Prognosis Inflammation Mortality
topic	COVID-19 Pronòstic mèdic Inflamació Mortalitat COVID-19 Prognosis Inflammation Mortality
description	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.
publishDate	2022
dc.date.none.fl_str_mv	2022
dc.type.none.fl_str_mv	info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion
format	article
status_str	publishedVersion
dc.identifier.none.fl_str_mv	https://hdl.handle.net/2445/186772
url	https://hdl.handle.net/2445/186772
dc.language.none.fl_str_mv	Inglés
language_invalid_str_mv	Inglés
dc.relation.none.fl_str_mv	Reproducció del document publicat a: https://doi.org/10.1007/s11606-022-07511-7 Journal of General Internal Medicine, 2022 https://doi.org/10.1007/s11606-022-07511-7
dc.rights.none.fl_str_mv	cc by-nc-nd (c) Rubio-Rivas, Manuel et al., 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess
rights_invalid_str_mv	cc by-nc-nd (c) Rubio-Rivas, Manuel et al., 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv	openAccess
dc.format.none.fl_str_mv	application/pdf
dc.publisher.none.fl_str_mv	Springer Nature
publisher.none.fl_str_mv	Springer Nature
dc.source.none.fl_str_mv	Articles publicats en revistes (Ciències Clíniques) reponame:Dipòsit Digital de la UB instname:Universidad de Barcelona
instname_str	Universidad de Barcelona
reponame_str	Dipòsit Digital de la UB
collection	Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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WHO Ordinal Scale and Inflammation Risk Categories in COVID-19

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