Determining which Covid-19 patients admitted to the ER will have a worse prognosis is key so that doctors can make the best decisions. Now, researchers from different hospitals in Spain have identified 7 clinical variables that can categorize the severity of the patient and their risk of dying, a key tool for making quick decisions.
Covid-19 has a highly variable course from asymptomatic disease at one extreme, to the development of life-threatening complications such as respiratory distress at the other.
It is known that the main factor that determines the prognosis is age, but there are other factors that influence such as sex, the presence or absence of underlying diseases and different alterations in laboratory tests or radiological studies. However, it is not easy to establish the prognosis accurately when assisting a person with Covid-19.
In this work published in Thorax and coordinated by the Gregorio Marañón General University Hospital, in collaboration with the La Paz University Hospital, the researchers identified that these 7 variables are sufficient to accurately determine the prognosis of patients: age, sex, shortness of breath; and some parameters of the blood such as oxygen saturation, the number of two types of leukocytes (neutrophils and lymphocytes) and the concentration of creatinine.
With these variables, they point out in their work, an index from 0 to 30 points can be made that allows patients to be classified by the risk of mortality at 30 days in such a way that a score less than or equal to 2 would indicate a low risk of mortality ( 0-2.1%), between 3 and 5 the risk would be moderate (4.7-6.3%), between 6 and 8 the risk would be high (10.6-19.5%) and between 9-30 the risk would be very high (27.7% -100%).
“It is a pioneering tool in the world for predicting the evolution of a Covid-19 patient and that will serve emergency physicians to be able to make agile decisions about the approach required by the patient, always supported by clinical criteria,” he explains. Juan Berenguer, from Hospital Gregorio Marañón and coordinator of the study.
The researchers consider that having a prognostic predictive index of high quality it is essential to improve the care of patients with Covid-19.
The development and validation of the indicand Covid-19 / SEIMC allows to classify patients with Covid-19 treated in hospital emergency services in different categories of mortality risk: low, intermediate, high and very high.
For example, patients with low risk (0-2 points) can be cared for on an outpatient basis, while those with high risk (6-8) or very high risk (9-30) must be admitted to the hospital or in units of care. critics.
Patients in a moderate risk category (3-5) could remain in observation units or hospitals for less complex patients.
The index Covid-19/SEIMC was developed with the study data [email protected], which included 4,035 patients admitted to 127 hospitals distributed throughout all regions of Spain during the first wave of the pandemic.
This tool has been developed by a multidisciplinary team of specialists in infectious diseases, epidemiologists and experts in biomedical statistics, following the international recommendations for the development of predictive prognostic models. Except for another index created in the United Kingdom, it is the first of its kind in the world and can facilitate and expedite the care of Covid-19 patients in emergency departments, especially at times of significant healthcare pressure.