Predictive Performance of National Early Warning Score 2 for Stratification of Critically ill COVID-19 Patients

Aims: To validate the ability of NEWS2 for predicting the severity of COVID-19. Additionally, we also intend to examine the impact of pre-existing comorbidities to produce an advanced COVID-19 disease.

Method: A multicenter prospective cohort was performed on 108 patients suffering from moderate intensity COVID-19 infection during October 2020 and November 2021. NEWS2 parameters were recorded on admission to generate an output score which then classified in accordance with NEWS2 reference scale into low, medium and high-risk categories. Each patient was followed till discharge or death for clinical progression of COVID-19 disease. The measures of validity and area under the curve for NEWS2 threshold scores were calculated to predict the clinical deterioration of COVID-19 disease.

Results: Overall 29.6% patients developed an advanced disease, out of which 21.8% patients died during treatment. NEWS2 score of 6 or more showed highest sensitivity (78.1%), specificity (94.8%) and the area under the curve (0.838) for predicting an adverse outcome. Among comorbidities, majority showed increased risk of clinical deterioration.

Conclusion: NEWS2 score of 6 or more at baseline showed good predictive ability to stratify patients with poor outcome who may later require an escalated care. However, we recommend more research to confirm our findings.