Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb;16(1):232-239.
doi: 10.1017/dmp.2020.324. Epub 2020 Sep 9.

Predictive Value of 5 Early Warning Scores for Critical COVID-19 Patients

Hai Hu  1 , Ni Yao  2 , Yanru Qiu  3
Affiliations

Predictive Value of 5 Early Warning Scores for Critical COVID-19 Patients

Hai Hu et al. Disaster Med Public Health Prep. 2022 Feb.

Abstract

Objectives: A simple evaluation tool for patients with novel coronavirus disease 2019 (COVID-19) could assist the physicians to triage COVID-19 patients effectively and rapidly. This study aimed to evaluate the predictive value of 5 early warning scores based on the admission data of critical COVID-19 patients.

Methods: Overall, medical records of 319 COVID-19 patients were included in the study. Demographic and clinical characteristics on admission were used for calculating the Standardized Early Warning Score (SEWS), National Early Warning Score (NEWS), National Early Warning Score2 (NEWS2), Hamilton Early Warning Score (HEWS), and Modified Early Warning Score (MEWS). Data on the outcomes (survival or death) were collected for each case and extracted for overall and subgroup analysis. Receiver operating characteristic curve analyses were performed.

Results: The area under the receiver operating characteristic curve for the SEWS, NEWS, NEWS2, HEWS, and MEWS in predicting mortality were 0.841 (95% CI: 0.765-0.916), 0.809 (95% CI: 0.727-0.891), 0.809 (95% CI: 0.727-0.891), 0.821 (95% CI: 0.748-0.895), and 0.670 (95% CI: 0.573-0.767), respectively.

Conclusions: SEWS, NEWS, NEWS2, and HEWS demonstrated moderate discriminatory power and, therefore, offer potential utility as prognostic tools for screening severely ill COVID-19 patients. However, MEWS is not a good prognostic predictor for COVID-19.

Keywords: COVID-19; infectious disease medicine; mortality.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Flow chart of cases exclusion. From all 367 cases, we excluded 21 cases missing information on oxygen saturation, 16 cases missing record on oxygen therapy and 11 cases missing information on mental status. Finally, we analyzed 319 cases.
FIGURE 2
FIGURE 2
The ROC curves of five EWSs for overall cases ROC: Receiver operating characteristic; NEWS: National Early Warning Score; NEWS2: National Early Warning Score2; HEWS: Hamilton Early Warning Score; MEWS: Modified Early Warning Score. SEWS: Standardized Early Warning Score.
FIGURE 3
FIGURE 3
Classification performances of five early warning scores (EWS) for subgroups. (A) The ROC curves of five EWSs in the subgroup of persons aged ≥65 years; (B) The ROC curves of five EWSs in the subgroup of persons aged <65 years. NEWS: National Early Warning Score; NEWS2: National Early Warning Score2; HEWS: Hamilton Early Warning Score; MEWS: Modified Early Warning Score. SEWS: Standardized Early Warning Score.
See this image and copyright information in PMC

References

    1. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433. doi: 10.1016/j.jaut.2020.102433 - DOI - PMC - PubMed
    1. Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-481. doi: 10.1016/S2213-2600(20)30079-5 - DOI - PMC - PubMed
    1. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513. doi: 10.1016/S0140-6736(20)30211-7 - DOI - PMC - PubMed
    1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5 - DOI - PMC - PubMed
    1. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-1062. doi: 10.1016/S0140-6736(20)30566-3 - DOI - PMC - PubMed

Publication types