• Aysun Tekin, Shahraz Qamar, Mayank Sharma, Romil Singh, Michael Malinchoc, Vikas Bansal, Neha Deo, Marija Bogojevic, Diana J Valencia-Morales, Simon Zec, Nika Zorko-Garbajs, Nikhil Sharma, Amos Lal, Devang K Sanghavi, Rodrigo Cartin-Ceba, Syed A Khan, Abigail T La Nou, Anusha Cherian, Igor B Zabolotskikh, Vishakha K Kumar, Rahul Kashyap, Allan J Walkey, Juan P Domecq, Hemang Yadav, Ognjen Gajic, Yewande E Odeyemi, and Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group.
• Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
• Mayo Clin. Proc. 2023 May 1; 98 (5): 736747736-747.

ObjectiveTo develop and validate an updated lung injury prediction score for coronavirus disease 2019 (COVID-19) (c-LIPS) tailored for predicting acute respiratory distress syndrome (ARDS) in COVID-19.Patients And MethodsThis was a registry-based cohort study using the Viral Infection and Respiratory Illness Universal Study. Hospitalized adult patients between January 2020 and January 2022 were screened. Patients who qualified for ARDS within the first day of admission were excluded. Development cohort consisted of patients enrolled from participating Mayo Clinic sites. The validation analyses were performed on remaining patients enrolled from more than 120 hospitals in 15 countries. The original lung injury prediction score (LIPS) was calculated and enhanced using reported COVID-19-specific laboratory risk factors, constituting c-LIPS. The main outcome was ARDS development and secondary outcomes included hospital mortality, invasive mechanical ventilation, and progression in WHO ordinal scale.ResultsThe derivation cohort consisted of 3710 patients, of whom 1041 (28.1%) developed ARDS. The c-LIPS discriminated COVID-19 patients who developed ARDS with an area under the curve (AUC) of 0.79 compared with original LIPS (AUC, 0.74; P<.001) with good calibration accuracy (Hosmer-Lemeshow P=.50). Despite different characteristics of the two cohorts, the c-LIPS's performance was comparable in the validation cohort of 5426 patients (15.9% ARDS), with an AUC of 0.74; and its discriminatory performance was significantly higher than the LIPS (AUC, 0.68; P<.001). The c-LIPS's performance in predicting the requirement for invasive mechanical ventilation in derivation and validation cohorts had an AUC of 0.74 and 0.72, respectively.ConclusionIn this large patient sample c-LIPS was successfully tailored to predict ARDS in COVID-19 patients.Copyright © 2023 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

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