Authors | Score name | Country of derivation | Development population | Pre-existing or COVID-specific? | Model outcome | Predictors | Original modelling approach | How are predictors combined? |
Subbe et al. [34] | MEWS# | UK | Hospital inpatients | Pre-existing (hospital patients) | Mortality, ICU admission or cardiac arrest (no specified timepoint) | Systolic blood pressure, pulse rate, respiratory rate, temperature, AVPU score | Clinical consensus | Points-based score |
Olsson et al. [26] | REMS# | Sweden | Patients presenting to emergency department | Pre-existing (emergency department patients) | Mortality (in-hospital) | Blood pressure, respiratory rate, pulse rate, Glasgow coma scale, oxygen saturation, age | Logistic regression | Points-based score |
Seymour et al. [10] | qSOFA | USA | Electronic health record encounters | Pre-existing (suspected infection) | Mortality (in-hospital) | Systolic hypotension [≤100 mmHg], tachypnoea [≥22 min−1], altered mentation | Logistic regression | Points-based score |
Lim et al. [11] | CURB65 | UK, New Zealand, Netherlands | Patients with community acquired pneumonia | Pre-existing (community-acquired pneumonia) | Mortality (30 days) | Confusion, urea >7 mmol·L−1, respiratory rate >30 min−1, low systolic (<90 mmHg) or diastolic (<60 mmHg) blood pressure), age>65 years | Logistic regression | Points-based score |
Royal College of Physicians [12] | NEWS2+ | UK | Hospital admissions | Pre-existing (hospital patients) | Mortality, ICU admission or cardiac arrest (24 h) | Respiratory rate, oxygen saturation, systolic blood pressure, pulse rate, level of consciousness or new confusion, temperature | Clinical consensus | Points-based score |
Bello-Chavolla et al. [28] | Bello-Chavolla | Mexico | Confirmed COVID-19 patients presenting in primary care | COVID-specific | Mortality (30 day) | Age≥65 years, diabetes, early-onset diabetes, obesity, age <40 years, chronic kidney disease, hypertension, immunosuppression (rheumatoid arthritis, lupus, HIV or immunosuppressive drugs) | Cox regression | Points-based score |
Caramelo et al. [29] | Caramelo¶ | Simulated data | Simulated data | COVID-specific | Mortality (period unspecified) | Age, hypertension, diabetes, cardiovascular disease, chronic respiratory disease, cancer | Logistic regression | Logistic regression |
Carr et al. [31] | “Carr final”, “Carr threshold” | UK | Inpatients with confirmed COVID-19 | COVID-specific | ICU admission or death (14 days from symptom onset) | NEWS2, CRP, neutrophils, estimated glomerular filtration rate, albumin, age | Regularized logistic regression with LASSO estimator | Regularized logistic regression |
Colombi et al. [35] | Colombi_clinical$ (clinical model only) | Italy | Inpatients with confirmed COVID-19 | COVID-specific | ICU admission or in-hospital mortality (period unspecified) | Age>68 years, cardiovascular disease, CRP>76 mg·L−1, LDH>347 U·L−1, platelets>180×10^9 L−1 | Logistic regression | Logistic regression |
Galloway et al. [36] | Galloway | UK | Inpatients with confirmed COVID-19 | COVID-specific | ICU admission or death during admission | Modified RALE score >3, oxygen saturation<93%, creatinine>100 μmol·L−1, neutrophils>8×10^9 L−1, age>40 years, chronic lung disease, CRP>40 mg·L−1, albumin<34 g·L−1, male gender, non-white ethnicity, hypertension, diabetes. | Logistic regression (LASSO) | Points-based score |
Guo et al. [37] | Guo | China | Inpatients with confirmed COVID-19 | COVID-specific | Deterioration within 14 days of admission | Age >50, underlying chronic disease (not defined), neutrophil/lymphocyte ratio>5, CRP>25 mg·L−1, d-dimer>800 ng·mL−1 | Cox regression | Points-based score |
Hall et al. [38] | TACTIC | UK | Inpatients with confirmed COVID-19 | COVID-specific | Admission to ICU or death during admission | Modified RALE score >3, age >40 years, male sex, non-white ethnicity, diabetes, hypertension, neutrophils>8×10^9 L−1, CRP>40 mg·L−1 | Logistic regression (LASSO) | Points-based score |
Hu et al. [39] | Hu | China | Inpatients with confirmed COVID-19 | COVID-specific | Mortality (in-hospital) | Age, CRP, lymphocytes, d-dimer (μg/mL) | Logistic regression | Logistic regression |
Huang et al. [40] | Huang | China | Inpatients with confirmed COVID-19 | COVID-specific | Progression to severe COVID (defined as respiratory rate≥30, oxygen saturation≤93% in the resting state or arterial blood oxygen partial pressure/oxygen concentration (FiO2)≤300 mmHg), 3–7 days from admission | CRP>10 mg·L−1, LDH>250 U·L−1, respiratory rate>24 min−1, comorbidity (hypertension, coronary artery disease, diabetes, obesity, chronic obstructive pulmonary disease, chronic kidney disease, obstructive sleep apnoea) | Logistic regression | Logistic regression |
Ji et al. [41] | Ji | China | Inpatients with confirmed COVID-19 | COVID-specific | Progression to severe COVID-19 at 10 days (defined as respiratory rate≥30, resting oxygen saturation≤93%, PaO2/FiO2≤300 mmHg, requirement of mechanical ventilation or worsening of lung CT findings) | Age (> 60 years), lymphocytes (≤1×10^9 L−1) LDH (<250, 250–500, >500 U L−1), comorbidity (hypertension, diabetes, cardiovascular disease, chronic lung disease, or HIV) | Cox regression | Points-based score |
Lu et al. [42] | Lu | China | Inpatients with suspected or confirmed COVID-19 | COVID-specific | Mortality (12 days) | Age≥60 years, CRP≥34 mg·L−1 | Cox regression | Points-based score |
Shi et al. [43] | Shi | China | Inpatients with confirmed COVID-19 | COVID-specific | Death or “severe” COVID-19 (not defined) over unspecified period | Age>50 years, male sex, hypertension | Not specified | Points-based score |
Xie et al. [44] | Xie | China | Inpatients with confirmed COVID-19 | COVID-specific | Mortality (in-hospital) | Age, lymphocytes, LDH, oxygen saturation | Logistic regression | Logistic regression |
Yan et al. [45] | Yan | China | Inpatients suspected of COVID-19 | COVID-specific | Mortality (period unspecified) | LDH>365 U·L−1, CRP>41.2 mg·L−1, lymphocyte percentage>14.7% | Decision-tree model with XG boost | Points-based score |
Zhang et al. [46] | “Zhang poor”, “Zhang death” | China | Inpatients with confirmed COVID-19 | COVID-specific | Mortality and poor outcome (ARDS, intubation or ECMO, ICU admission) as separate models; no timepoint specified | Age, sex, neutrophils, lymphocytes, platelets, CRP, creatinine | Logistic regression (LASSO) | Logistic regression |
#MEWS and REMS were evaluated among people with COVID-19 by Hu et al. [47], and thus were included in the present study.
¶No model intercept was available; the intercepts for these models were therefore calibrated to the validation dataset, using the model linear predictors as offset terms.
+Using oxygen scale 1 for all participants, except for those with target oxygen saturation ranges of 88–92%, e.g. in hypercapnic respiratory failure, when scale 2 is used, as recommended [12].
MEWS: modified early warning score; qSOFA: quick sequential (sepsis-related) organ failure assessment; REMS: rapid emergency medicine score; NEWS: national early warning score; TACTIC: therapeutic study in pre-ICU patients admitted with COVID-19; AVPU: Alert/responds to voice/responsive to pain/unresponsive; CRP: C-reactive protein; LDH: lactate dehydrogenase; RALE: radiographic assessment of lung edema; ARDS: acute respiratory distress syndrome; ICU: intensive care unit; ECMO: extra-corporeal membrane oxygenation.
Units, unless otherwise specified, are: age in years; respiratory rate in breaths per minute; heart rate in beats per minute; blood pressure in mmHg; temperature in °C; oxygen saturation in %; CRP in mg/L; LDH in U/L; neutrophils, lymphocytes, total white cell count and platelets×10^9 L−1; D-dimer in ng/mL; creatinine in μmol/L; estimated glomerular filtration rate in mL/min/1.73 m2, albumin in g/L.