• Francisco Martín-Rodríguez, José L Martín-Conty, Ancor Sanz-García, RodríguezVirginia CarbajosaVCEmergency Department, Hospital Universitario Rio Hortega de Valladolid, Gerencia Regional de Salud de Castilla y León (SACYL), c/Dulzaina, 2, 47012 Valladolid, Spain., RabbioneGuillermo OrtegaGO0000-0002-7840-6145Data Analysis Unit, Health Research Institute, Hospital de la Princesa, Madrid (IIS-IP), C/Diego de León, 62, 28006 Madrid, Spain., Irene Cebrían Ruíz, José R Oliva Ramos, Enrique Castro Portillo, Begoña Polonio-López, Rodrigo Enríquez de Salamanca Gambarra, Marta Gómez-Escolar Pérez, and Raúl López-Izquierdo.
• Advanced Clinical Simulation Centre, Advanced Life Support Unit, Emergency Medical Services, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain.
• J Pers Med. 2021 Mar 2; 11 (3).

AbstractEarly warning scores (EWSs) help prevent and recognize and thereby act as the first signs of clinical and physiological deterioration. The objective of this study is to evaluate different EWSs (National Early Warning Score 2 (NEWS2), quick sequential organ failure assessment score (qSOFA), Modified Rapid Emergency Medicine Score (MREMS) and Rapid Acute Physiology Score (RAPS)) to predict mortality within the first 48 h in patients suspected to have Coronavirus disease 2019 (COVID-19). We conducted a retrospective observational study in patients over 18 years of age who were treated by the advanced life support units and transferred to the emergency departments between March and July of 2020. Each patient was followed for two days registering their final diagnosis and mortality data. A total of 663 patients were included in our study. Early mortality within the first 48 h affected 53 patients (8.3%). The scale with the best capacity to predict early mortality was the National Early Warning Score 2 (NEWS2), with an area under the curve of 0.825 (95% CI: 0.75-0.89). The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive patients presented an area under the curve (AUC) of 0.804 (95% CI: 0.71-0.89), and the negative ones with an AUC of 0.863 (95% CI: 0.76-0.95). Among the EWSs, NEWS2 presented the best predictive power, even when it was separately applied to patients who tested positive and negative for SARS-CoV-2.

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