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. 2022 Mar 13;12(3):703.
doi: 10.3390/diagnostics12030703.

Evaluation and Comparison of the Predictive Value of 4C Mortality Score, NEWS, and CURB-65 in Poor Outcomes in COVID-19 Patients: A Retrospective Study from a Single Center in Romania

Cosmin Citu  1 , Florin Gorun  1 , Andrei Motoc  2 , Adrian Ratiu  1 , Oana Maria Gorun  3 , Bogdan Burlea  3 , Octavian Neagoe  4 , Ioana Mihaela Citu  5 , Ovidiu Rosca  6 , Felix Bratosin  6 , Mirela Loredana Grigoras  2 , Raul Patrascu  7 , Daniel Malita  8
Affiliations

Evaluation and Comparison of the Predictive Value of 4C Mortality Score, NEWS, and CURB-65 in Poor Outcomes in COVID-19 Patients: A Retrospective Study from a Single Center in Romania

Cosmin Citu et al. Diagnostics (Basel). .

Abstract

To date, the COVID-19 pandemic has caused millions of deaths across the world. Prognostic scores can improve the clinical management of COVID-19 diagnosis and treatment. The objective of this study was to assess the predictive role of 4C Mortality, CURB-65, and NEWS in COVID-19 mortality among the Romanian population. A single-center, retrospective, observational study was conducted on patients with reverse transcriptase-polymerase chain reaction (RT-PCR)-proven COVID-19 admitted to the Municipal Emergency Clinical Hospital of Timisoara, Romania, between 1 October 2020 and 15 March 2021. Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were performed to determine the discrimination accuracy of the three scores. The mean values of the risk scores were higher in the non-survivors group (survivors group vs. non-survivors group: 8 vs. 15 (4C Mortality Score); 3 vs. 8.5 (NEWS); 1 vs. 3 (CURB-65)). In terms of mortality risk prediction, the NEWS performed best, with an AUC of 0.86, and the CURB-65 score performed poorly, with an AUC of 0.80. CURB-65, NEWS, and 4C Mortality scores were significant mortality predictors in the analysis, with acceptable calibration. Among the scores assessed in our study, NEWS had the highest performance in predicting in-hospital mortality in COVID-19 patients. Thus, the findings from this study suggest that the use of NEWS may be beneficial to the early identification of high-risk COVID-19 patients and the provision of more aggressive care to reduce mortality associated with COVID-19.

Keywords: 4C Mortality; COVID-19; CURB-65; NEWS; mortality; prediction.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Receiver operating characteristic curve of clinical risk scores in predicting mortality.
Figure 2
Figure 2
Kaplan–Meier survival curves of hospitalized COVID-19 patients: (a) according to 4C Mortality Score cutoff value of 2; (b) according to 4C Mortality Score cutoff value of 8.
Figure 3
Figure 3
Kaplan–Meier survival curves of hospitalized COVID-19 patients: (a) according to 4C Mortality Score cutoff value of 11; (b) according to 4C Mortality Score cutoff value of 14.
Figure 4
Figure 4
Kaplan–Meier survival curves of hospitalized COVID-19 patients according to 4C Mortality Score risk.
Figure 5
Figure 5
Kaplan–Meier survival curves of hospitalized COVID-19 patients: (a) according to NEWS cutoff value of 3; (b) according to CURB-65 cutoff value of 2.
See this image and copyright information in PMC

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