• Clin Med (Lond) · Mar 2021

    National Early Warning Score 2 (NEWS2) to identify inpatient COVID-19 deterioration: a retrospective analysis.

    • Kenneth F Baker, Aidan T Hanrath, Schim van der LoeffInaITranslational and Clinical Research Institute, Newcastle University, UK., Lesley J Kay, Jonathan Back, and Christopher Ja Duncan.
    • Translational and Clinical Research Institute, Newcastle University, UK and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
    • Clin Med (Lond). 2021 Mar 1; 21 (2): 848984-89.

    IntroductionWe sought to provide the first report of the use of NEWS2 monitoring to pre-emptively identify clinical deterioration within hospitalised COVID-19 patients.MethodsConsecutive adult admissions with PCR-confirmed COVID-19 were included in this single-centre retrospective UK cohort study. We analysed all electronic clinical observations recorded within 28 days of admission until discharge or occurrence of a serious event, defined as any of the following: initiation of respiratory support, admission to intensive care, initiation of end of life care, or in-hospital death.Results133/296 (44.9%) patients experienced at least one serious event. NEWS2 ≥ 5 heralded the first occurrence of a serious event with sensitivity 0.98 (95% CI 0.96-1.00), specificity 0.28 (0.21-0.35), positive predictive value (PPV) 0.53 (0.47-0.59), and negative predictive value (NPV) 0.96 (0.90-1.00). The NPV (but not PPV) of NEWS2 monitoring exceeded that of other early warning scores including the Modified Early Warning Score (MEWS) (0.59 [0.52-0.66], p<0.001) and quick Sepsis Related Organ Failure Assessment (qSOFA) score (0.58 [0.51-0.65], p<0.001).ConclusionOur results support the use of NEWS2 monitoring as a sensitive method to identify deterioration of hospitalised COVID-19 patients, albeit at the expense of a relatively high false-trigger rate.© Royal College of Physicians 2021. All rights reserved.

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