National Early Warning Score 2 (NEWS2) better predicts critical Coronavirus Disease 2019 (COVID-19) illness than COVID-GRAM, a multi-centre study

Infection. 2021 Oct;49(5):1033-1038. doi: 10.1007/s15010-021-01620-x. Epub 2021 May 10.

Abstract

Purpose: Clinical scores to rapidly assess the severity illness of Coronavirus Disease 2019 (COVID-19) could be considered of help for clinicians. Recently, a specific score (named COVID-GRAM) for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection, based on a nationwide Chinese cohort, has been proposed. We routinely applied the National Early Warning Score 2 (NEWS2) to predict critical COVID-19. Aim of this study is to compare NEWS2 and COVID-GRAM score.

Methods: We retrospectively analysed data of 121 COVID-19 patients admitted in two Clinics of Infectious Diseases in the Umbria region, Italy. The primary outcome was critical COVID-19 illness defined as admission to the intensive care unit, invasive ventilation, or death. Accuracy of the scores was evaluated with the area under the receiver-operating characteristic curve (AUROC). Differences between scores were confirmed used Hanley-McNeil test.

Results: The NEWS2 AUROC curve measured 0.87 (standard error, SE 0.03; 95% CI 0.80-0.93; p < 0.0001). The COVID-GRAM score AUROC curve measured 0.77 (SE 0.04; 95% CI 0.68-0.85; p < 0.0001). Hanley-McNeil test showed that NEWS2 better predicted severe COVID-19 (Z = 2.03).

Conclusions: The NEWS2 showed superior accuracy to COVID-GRAM score for prediction of critical COVID-19 illness.

Keywords: COVID-19; COVID-GRAM; NEWS2; National Early Warning Score 2; SARS-CoV-2.

Publication types

  • Multicenter Study

MeSH terms

  • COVID-19*
  • Critical Illness
  • Early Warning Score*
  • Humans
  • Retrospective Studies
  • SARS-CoV-2