COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

COVID-19 Evidence Alerts needs your support. If our service is of value to you, please consider donating to keep it going. Learn more Donate now

Clinical Prediction Guide Jamal MH, Doi SA, AlYouha S, et al. A biomarker based severity progression indicator for COVID-19: the Kuwait prognosis indicator score. Biomarkers. 2020 Dec;25(8):641-648. doi: 10.1080/1354750X.2020.1841296. Epub 2020 Nov 24.

BACKGROUND: COVID-19 is a worldwide pandemic that is mild in most patients but can result in a pneumonia like illness with progression to acute respiratory distress syndrome and death. Predicting the disease severity at time of diagnosis can be helpful in prioritizing hospital admission and resources.

METHODS: We prospectively recruited 1096 consecutive patients of whom 643 met the inclusion criterion with COVID-19 from Jaber Hospital, a COVID-19 facility in Kuwait, between 24 February and 20 April 2020. The primary endpoint of interest was disease severity defined algorithmically. Predefined risk variables were collected at the time of PCR based diagnosis of the infection. Prognostic model development used 5-fold cross-validated regularized logit regression. The model was externally validated against data from Wuhan, China.

RESULTS: There were 643 patients with clinical course data of whom 94 developed severe COVID-19. In the final model, age, CRP, procalcitonin, lymphocyte percentage, monocyte percentages and serum albumin were independent predictors of a more severe illness course. The final prognostic model demonstrated good discrimination, and both discrimination and calibration were confirmed with an external dataset.

CONCLUSION: We developed and validated a simple score calculated at time of diagnosis that can predict patients with severe COVID-19 disease reliably and that has been validated externally. The KPI score calculator is now available online at

Discipline / Specialty Area Score
Hospital Doctor/Hospitalists
Internal Medicine
Emergency Medicine
Infectious Disease
Intensivist/Critical Care
Comments from MORE raters

Emergency Medicine rater

This is a surprising study about risk stratification, which deserves to be taken into account.

Infectious Disease rater

This preliminary data needs much validation.

Infectious Disease rater


Intensivist/Critical Care rater

This article reports a fair predictive value of a composite score calibrated to detect severe forms of COVID-19. If confirmed in an international setting, this score could represent an added value when ICU triage is considered.

Intensivist/Critical Care rater

The question always arises: is this predictive model of severity of disease universally applicable universally? Thus, it is of interest but would I use it on daily basis are two different things.