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. 2024 Oct 22;19(10):e0309922.
doi: 10.1371/journal.pone.0309922. eCollection 2024.

The 123 COVID SCORE: A simple and reliable diagnostic tool to predict in-hospital death in COVID-19 patients on hospital admission

Małgorzata Ostrowska  1 , Michał Kasprzak  1 , Tomasz Fabiszak  1 , Jacek Gajda  2 , Natalia Jaje-Rykowska  3 , Piotr Michalski  1 , Beata Moczulska  3 , Paulina Nowek  3 , Maciej Piasecki  1 , Marta Pilaczyńska-Cemel  4 , Przemysław Podhajski  1 , Paulina Prudzic  1 , Dominika Stępniak  3 , Damian Świątkowski  1 , Maciej Żechowicz  3 , Robert Gajda  2 , Leszek Gromadziński  3 , Jacek Kryś  1 , Aldona Kubica  1 , Grzegorz Przybylski  4 , Paweł Szymański  5 , Jacek Kubica  1
Affiliations

The 123 COVID SCORE: A simple and reliable diagnostic tool to predict in-hospital death in COVID-19 patients on hospital admission

Małgorzata Ostrowska et al. PLoS One. .

Abstract

Background: Patients hospitalized due to Coronavirus disease 2019 (COVID-19) are still burdened with high risk of death. The aim of this study was to create a risk score predicting in-hospital mortality in COVID-19 patients on hospital admission.

Methods: Independent mortality predictors identified in multivariate logistic regression analysis were used to build the 123 COVID SCORE. Diagnostic performance of the score was evaluated using the area under the receiver-operating characteristic curve (AUROC).

Results: Data from 673 COVID-19 patients with median age of 70 years were used to build the score. In-hospital death occurred in 124 study participants (18.4%). The final score is composed of 3 variables that were found predictive of mortality in multivariate logistic regression analysis: (1) age, (2) oxygen saturation on hospital admission without oxygen supplementation and (3) percentage of lung involvement in chest computed tomography (CT). Four point ranges have been identified: 0-5, 6-8, 9-11 and 12-17, respectively corresponding to low (1.5%), moderate (13.4%), high (28.4%) and very high (57.3%) risk of in-hospital death. The 123 COVID SCORE accuracy measured with the AUROC was 0.797 (95% CI 0.757-0.838; p<0.0001) in the study population and 0.774 (95% CI 0.728-0.821; p<0.0001) in an external validation cohort consisting of 558 COVID-19 patients.

Conclusions: The 123 COVID SCORE containing merely 3 variables: age, oxygen saturation, and percentage of lung involvement assessed with chest CT is a simple and reliable tool to predict in-hospital death in COVID-19 patients upon hospital admission.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The 123 COVID SCORE.
Histogram presenting percentage of patients from the study group receiving particular numbers of points and classification to low, moderate, high or very high risk of in-hospital death. Mortality rates are provided for study and validation groups.
Fig 2
Fig 2. How to calculate the 123 COVID SCORE?.
Fig 3
Fig 3. The 123 COVID SCORE accuracy in the study group measured with the area under receiver operating curve (AUROC).
Fig 4
Fig 4. The 123 COVID SCORE accuracy in the validation group measured with the area under receiver operating curve (AUROC).
See this image and copyright information in PMC

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