COVID SKÓRE - PŘÍNOS V PROGNOSTICKÉ STRATIFIKACI NEMOCNÝCH S COVID-19

Covid skóre a prognostická stratifikace nemocných

Abstract

COVID SCORE – THE CONTRIBUTION IN PROGNOSTIC STRATIFICATION OF PATIENTS WITH COVID-19

The COVID-19 disease, caused by the SARS-CoV-2 virus, induces a number of changes in the blood count. The Covid Score (CS) is a variable, calculated from 10 parameters of the blood count, enabling the prediction of a severity of COVID-19 disease. CS values ​​can range from 0 to 28. In the pilot study by Linssen et al, a CS value in the range of 0-3 was associated with a clinically uncomplicated course of the disease, while values ​​of 4 or more predicted a severe course with the need for intensive care or a fatal outcome. The aim of the work was to verify the prognostic potential of CS in a group of 76 patients with proven COVID-19 infection examined at the Olomouc University Hospital between December 2021 and February 2022. A total of 44 (57.9%) patients had a CS value in the range of 0-3 and 32 (42.1%) of patients had CS 4 or more. Patients with CS ≥ 4 were more likely to require hospitalization in intensive care units (78.1 vs. 20.5%, p < 0.0001) and artificial ventilatory support (75.0 vs. 20.5%, p < 0.0001). The mortality rate was non-significantly higher in the group with CS ≥ 4 compared to patients with CS 0-3 (25.0 vs. 11.4%, p = 0.119). The work also demonstrated the association between the CS value and already known risk factors for the complicated course of COVID-19. The median value of D-dimers and CRP was significantly higher at diagnosis in patients with CS value ≥ 4 (2006.0 vs. 594.5 ug/l, p < 0.0001; respectively 132.6 vs. 36.9 mg /l, p < 0.0001) and inflammatory lung infiltration was also detected significantly more often at admission (96.9% vs. 47.7%, p < 0.0001). The results of the work confirmed the prognostic potential of CS in predicting the complicated course of the COVID-19 disease, with the need for hospitalization and ventilation support. During the prognostic stratification of the patients, it is always necessary to consider the patient´s risk factors, vaccination status and specific antiviral therapy administered in the context of the currently dominant variants of the SARS-CoV-2 virus.