Covid-19: Researchers develop tool to identify patients with highest risk of deterioration

Researchers in the United Kingdom, including an Indian-origin scientist, develop a new risk-stratification tool that can precisely speculate the likelihood of deterioration in Covid-19 hospitalized patients.

According to the researchers, the recently developed online tool could guide clinicians’ decision-making — helping to improve patient outcomes and save lives.

Co-author Mahdad Noursadeghi, Professor at University College London, said: “Accurate risk-stratification at the point of admission to hospital will give doctors greater confidence about clinical decisions and planning ahead for the needs of individual patients.”

4C Deterioration Score

The tool examined 11 measurements routinely collected from patients. These include age, gender, and physical measurements (such as oxygen levels) along with some standard laboratory tests and calculates a percentage risk of deterioration, known as the ‘4C Deterioration Score’.

This tool is an advanced version of the Consortium’s previous work -- ‘4C Mortality Score’ -- to predict the percentage risk of death from Covid-19 after admission to hospital.

“The addition of the new 4C Deterioration Score alongside the 4C Mortality Score will provide clinicians with an evidence-based measure to identify those who will need increased hospital support during their admission, even if they have a low risk of death,” Noursadeghi informed.

For the study, the team used a multivariable logistic regression model (where several measures are used to predict an outcome). The researchers tested the 11 measures against the large patient cohort, to establish how, and to what degree each of the measures affected the likelihood of deterioration.

“Our analysis provides very encouraging evidence that the 4C Deterioration tool is likely to be useful for clinicians across England, Scotland, and Wales to support clinical decision-making,” said first author Rishi Gupta from University College London.

The authors of the study further suggested that the tool could also be used in other countries for risk-stratification, but should first be evaluated to test its accuracy in these settings.

The findings of the study were published in the journal The Lancet Respiratory Medicine.