• José-Joaquín Alfaro-Martínez, Juan Calbo Mayo, María Molina Cifuentes, Pedro Abizanda Soler, Sergio Guillén Martínez, Yulema Rodríguez Marín, Alejandro Esteban Sirvent Segovia, Ana Nuñez Ares, Marina Alcaraz Barcelona, Gema Paterna Mellinas, Encarna Cuesta Vizcaíno, Elisa Martínez Alfaro, Solís García Del Pozo Julián J 0000-0002-8361-2090 Infectious Diseases Unit, Albacete University Hospital Complex, Albacete, Spain., and on behalf the ALBA-COVID score group.
• Department of Endocrinology and Nutrition, Albacete University Hospital Complex, Albacete, Spain.
• Curr Med Res Opin. 2021 May 1; 37 (5): 719-726.

BackgroundCOVID-19 has a wide range of symptoms reported, which may vary from very mild cases (even asymptomatic) to deadly infections. Identifying high mortality risk individuals infected with the SARS-CoV-2 virus through a prediction instrument that uses simple clinical and analytical parameters at admission can help clinicians to focus on treatment efforts in this group of patients.MethodsData was obtained retrospectively from the electronic medical record of all COVID-19 patients hospitalized in the Albacete University Hospital Complex until July 2020. Patients were split into two: a generating and a validating cohort. Clinical, demographical and laboratory variables were included. A multivariate logistic regression model was used to select variables associated with in-hospital mortality in the generating cohort. A numerical and subsequently a categorical score according to mortality were constructed (A: mortality from 0% to 5%; B: from 5% to 15%; C: from 15% to 30%; D: from 30% to 50%; E: greater than 50%). These scores were validated with the validation cohort.ResultsVariables independently related to mortality during hospitalization were age, diabetes mellitus, confusion, SaFiO2, heart rate and lactate dehydrogenase (LDH) at admission. The numerical score defined ranges from 0 to 13 points. Scores included are: age ≥71 years (3 points), diabetes mellitus (1 point), confusion (2 points), onco-hematologic disease (1 point), SaFiO2 ≤ 419 (3 points), heart rate ≥ 100 bpm (1 point) and LDH ≥ 390 IU/L (2 points). The area under the curve (AUC) for the numerical and categorical scores from the generating cohort were 0.8625 and 0.848, respectively. In the validating cohort, AUCs were 0.8505 for the numerical score and 0.8313 for the categorical score.ConclusionsData analysis found a correlation between clinical admission parameters and in-hospital mortality for COVID-19 patients. This correlation is used to develop a model to assist physicians in the emergency department in the COVID-19 treatment decision-making process.

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