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    ABC2 HGNC-SPH risk score for in-hospital mortality in COVID-19 MESHD patients: development, external validation and comparison with other available scores

    Authors: Milena Soriano Marcolino; Magda Carvalho Pires; Lucas Emanuel Ferreira Ramos; Rafael Tavares Silva; Luana Martins Oliveira; Rafael Lima Rodrigues de Carvalho; Rodolfo Lucas Silva Mourato; Adrian Sanchez Montalva; Berta Raventos; Fernando Anschau; Jose Miguel Chatkin; Matheus Carvalho Alves Nogueira; Milton Henriques Guimaraes Junior; Giovanna Grunewald Vietta; Helena Duani; Daniela Ponce; Patricia Klarmann Ziegelmann; Luis Cesar de Castro; Karen Brasil Ruschel; Christiane Correa Rodrigues Cimini; Saionara Cristina Francisco; Maiara Anschau Floriani; Guilherme Fagundes Nascimento; Barbara Lopes Farace; Luanna da Silva Monteiro; Maira Viana Rego Souza e Silva; Thais Lorenna Souza Sales; Karina Paula Medeiros Prado Martins; Israel Junior Borges do Nascimento; Tatiani Oliveira Fereguetti; Daniel Taiar Marinho Oliveira Ferrara; Fernando Antonio Botoni; Ana Paula Beck da Silva Etges; Eric Boersma; Carisi Anne Polanczyk; Alexandre Vargas Schwarbold; Amanda Oliveira Maurilio; Ana Luiza Bahia Alves Scotton; Andre Pinheiro Weber; Andre Soares de Moura Costa; Andressa Barreto Glaeser; Angelica Aparecida Coelho Madureira; Angelinda Rezende Bhering; Bruno Mateus Castro; Carla Thais Candida Alves da Silva; Carolina Marques Ramos; Caroline Danubia Gomes; Cintia Alcantara de Carvalho; Daniel Vitorio Silveira; Diego Henrique de Vasconcelos; Edilson Cezar; Elayne Crestani Pereira; Emanuele Marianne Souza Kroger; Felipe Barbosa Vallt; Fernanda Barbosa Lucas; Fernando Graca Aranha; Frederico Bartolazzi; Gabriela Petry Crestani; Gisele Alsina Nader Bastos; Glicia Cristina de Castro Madeira; Helena Carolina Noal; Heloisa Reniers Vianna; Henrique Cerqueira Guimaraes; Isabela Moraes Gomes; Israel Molina Romero; Joanna dArc Lyra Batista; Joice Coutinho de Alvarenga; Julia Di Sabatino Santos Guimaraes; Julia Drumond Parreiras de Morais; Juliana Machado Rugolo; Karen Cristina Jung Rech Pontes; Kauane Aline Maciel dos Santos; Leonardo Seixas de Oliveira; Lilian Santos Pinheiro; Liliane Souto Pacheco; Lucas de Deus Sousa; Luciana Siuves Ferreira Couto; Luciane Kopittke; Luis Cesar Souto de Moura; Luisa Elem Almeida Santos; Maderson Alvares de Souza Cabral; Maira Dias Souza; Marcela Goncalves Trindade Tofani; Marcelo Carneiro; Marcus Vinicius de Melo Andrade; Maria Angelica Pires Ferreira; Maria Aparecida Camargos Bicalho; Maria Clara Pontello Barbosa Lima; Mariana Frizzo de Godoy; Marilia Mastrocolla de Almeida Cardoso; Meire Pereira de Figueiredo; Natalia da Cunha Severino Sampaio; Natalia Lima Rangel; Natalia Trifiletti Crespo; Neimy Ramos de Oliveira; Pedro Ledic Assaf; Petronio Jose de Lima Martelli; Rafaela dos Santos Charao de Almeida; Raphael Castro Martins; Raquel Lutkmeier; Reginaldo Aparecido Valacio; Renan Goulart Finger; Ricardo Bertoglio Cardoso; Roberta Pozza; Roberta Xavier Campos; Rochele Mosmann Menezes; Roger Mendes de Abreu; Rufino de Freitas Silva; Silvana Mangeon Mereilles Guimaraes; Silvia Ferreira Araujo; Susany Anastacia Pereira; Talita Fischer Oliveira; Tatiana Kurtz; Thainara Conceicao de Oliveira; Thaiza Simonia Marinho Albino de Araujo; Thulio Henrique Oliveira Diniz; Veridiana Baldon dos Santos Santos; Virginia Mara Reis Gomes; Vitor Augusto Lima do Vale; Yuri Carlotto Ramires

    doi:10.1101/2021.02.01.21250306 Date: 2021-02-03 Source: medRxiv

    Objective: To develop and validate a rapid scoring system at hospital admission for predicting in-hospital mortality in patients hospitalized with coronavirus disease MESHD 19 ( COVID-19 MESHD), and to compare this score with other existing ones. Design: Cohort study Setting: The Brazilian COVID-19 MESHD Registry has been conducted in 36 Brazilian hospitals in 17 cities. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients that were admitted between March-July, 2020. The model was then validated in the 1054 patients admitted during August-September, as well as in an external cohort of 474 Spanish patients. Participants: Consecutive symptomatic patients ([≥]18 years old) with laboratory confirmed COVID-19 MESHD admitted to participating hospitals. Patients who were transferred between hospitals and in whom admission data from the first hospital or the last hospital were not available were excluded, as well those who were admitted for other reasons and developed COVID-19 MESHD symptoms during their stay. Main outcome measures: In-hospital mortality Results: Median (25th-75th percentile) age of the model-derivation cohort was 60 (48-72) years, 53.8% were men, in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. From 20 potential predictors, seven significant variables were included in the in-hospital mortality risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein HGNC, SpO2/FiO2 ratio, platelet count and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829 to 0.859), which was confirmed in the Brazilian (0.859) and Spanish (0.899) validation cohorts. Our ABC2 HGNC-SPH score showed good calibration in both Brazilian cohorts, but, in the Spanish cohort, mortality was somewhat underestimated in patients with very high (>25%) risk. The ABC2 HGNC-SPH score is implemented in a freely available online risk calculator (https://abc2sph.com/). Conclusions: We designed and validated an easy-to-use rapid scoring system based on characteristics of COVID-19 MESHD patients commonly available at hospital presentation, for early stratification for in-hospital mortality risk of patients with COVID-19 MESHD.

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MeSH Disease
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