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Observational Study
. 2020 Jun 29;35(25):e234.
doi: 10.3346/jkms.2020.35.e234.

Prognostic Accuracy of the SIRS, qSOFA, and NEWS for Early Detection of Clinical Deterioration in SARS-CoV-2 Infected Patients

Jong Geol Jang #  1 , Jian Hur #  2 , Kyung Soo Hong  1 , Wonhwa Lee  3 , June Hong Ahn  4
Affiliations
Observational Study

Prognostic Accuracy of the SIRS, qSOFA, and NEWS for Early Detection of Clinical Deterioration in SARS-CoV-2 Infected Patients

Jong Geol Jang et al. J Korean Med Sci. .

Abstract

Background: The case fatality rate of coronavirus disease 2019 (COVID-19) is estimated to be between 4.3% and 11.0%. Currently there is no effective antiviral treatment for COVID-19. Thus, early recognition of patients at high risk is important.

Methods: We performed a retrospective observational study of 110 patients with severe acute respiratory syndrome coronavirus 2 infection. We compared the effectiveness of three scoring systems: the Systemic Inflammatory Response Syndrome (SIRS), quick Sequential Organ Failure Assessment (qSOFA), and National Early Warning Score (NEWS) systems, for predicting the prognosis of COVID-19. The area under the receiver operating characteristic curve (AUROC) was used for these assessments, and Kaplan-Meier survival curves were used to identify the cumulative risk for 28-day mortality according to the NEWS stratification.

Results: For predicting 28-day mortality, NEWS was superior to qSOFA (AUROC, 0.867 vs. 0.779, P < 0.001), while there was no significant difference between NEWS and SIRS (AUROC, 0.867 vs. 0.639, P = 0.100). For predicting critical outcomes, NEWS was superior to both SIRS (AUROC, 0.918 vs. 0.744, P = 0.032) and qSOFA (AUROC, 0.918 vs. 0.760, P = 0.012). Survival time was significantly shorter for patients with NEWS ≥ 7 than for patients with NEWS < 7.

Conclusion: Calculation of the NEWS at the time of hospital admission can predict critical outcomes in patients with COVID-19. Early intervention for high-risk patients can thereby improve clinical outcomes in COVID-19 patients.

Keywords: COVID-19; NEWS; Outcome; Prediction.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Comparison of SIRS, qSOFA, and NEWS for predicting clinical outcomes of COVID-19.
AUROC = Area under a receiver operating characteristic, ICU = intensive care unit, NEWS = National EarlyWarning Score, qSOFA = Quick Sepsis-related Organ Failure Assessment, SIRS = Systemic Inflammatory Response Syndrome.
Fig. 2
Fig. 2. Kaplan Meier survival curves for cumulative risk of 28-day mortality according to the different stratifications of the NEWS.
NEWS = National Early Warning Score.
See this image and copyright information in PMC

Comment in

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