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The National Early Warning Score 2 with Age and Body Mass Index (NEWS2 Plus) to Determine Patients with Severe COVID-19 Pneumonia.

Konlawij TrongtrakulPattraporn TajarernmuangAtikun LimsukonTheerakorn TheerakittikulNutchanok NiyatiwatchanchaiKarjbundid SurasitPimpimok GlunriangsangChalerm LiwsrisakunChaiwat BumroongkitChaicharn PothiratJuthamas InchaiWarawut ChaiwongPanida ChanayatAthavudh Deesomchok
Published in: Journal of clinical medicine (2024)
(1) Background: Early identification of severe coronavirus disease 2019 (COVID-19) pneumonia at the initial phase of hospitalization is very crucial. To address this, we validated and updated the National Early Warning Score 2 (NEWS2) for this purpose. (2) Methods: We conducted a study on adult patients with COVID-19 infection in Chiang Mai, Thailand, between May 2021 and October 2021. (3) Results: From a total of 725 COVID-19 adult patients, 350 (48.3%) patients suffered severe COVID-19 pneumonia. In determining severe COVID-19 pneumonia, NEWS2 and NEWS2 + Age + BMI (NEWS2 Plus) showed the C-statistic values of 0.798 (95% CI, 0.767-0.830) and 0.821 (95% CI, 0.791-0.850), respectively. The C-statistic values of NEWS2 Plus were significantly improved compared to those of NEWS2 alone ( p = 0.012). Utilizing a cut-off point of five, NEWS2 Plus exhibited better sensitivity and negative predictive value than the traditional NEWS2, with values of 99.7% vs. 83.7% and 98.9% vs. 80.7%, respectively. (4) Conclusions: The incorporation of age and BMI into the traditional NEWS2 score enhanced the efficacy of determining severe COVID-19 pneumonia. Physicians can rely on NEWS2 Plus (NEWS2 + Age + BMI) as a more effective decision-making tool for triaging COVID-19 patients during early hospitalization.
Keyphrases
  • coronavirus disease
  • sars cov
  • body mass index
  • early onset
  • decision making
  • weight gain
  • intensive care unit
  • respiratory failure
  • physical activity
  • extracorporeal membrane oxygenation
  • mechanical ventilation