Knight et al reported the 4C Mortality Score for a patient with COVID-19. This can help to identify a patient who may require more aggressive management. The authors are from multiple institutions in the United Kingdom belonging to the ISARIC Coronavirus Clinical Characterisation Consortium (4C).
Patient selection: adult >= 18 years admitted to the hospital with COVID-19
Parameters:
(1) age in years
(2) sex at birth
(3) number of comorbidities
(4) respiratory rate in breaths per minute
(5) peripheral oxygen saturation in percent while on room air
(6) Glasgow coma scale (GCS)
(7) serum urea in mmol/L
(8) serum C-reactive protein (CRP) in mg/dL
Parameter
Finding
Points
age in years
< 50 years of age
0
50 to 59 years
2
60 to 69 years
4
70 to 79 years
6
>= 80 years
7
sex at birth
female
0
male
1
number of comorbidities
0
0
1
1
>= 2
2
respiratory rate
< 20 breaths/min
0
20 to 29 breaths/min
1
>= 30 breaths/min
2
oxygen saturation
>= 92%
0
< 92%
2
GCS
15
0
3 to 14
2
serum urea
< 7 mmol/L
0
7 to 14 mmol/L
1
> 14 mmol/L
3
serum CRP
< 50 mg/dL
0
50 to 99 mg/dL
1
>= 100 mg/dL
2
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 21
• The higher the score the greater the risk of mortality.
Score
Risk Group
Percent Mortality
0 to 3
low
1.2-1.7%
4 to 8
intermediate
9.1-9.9%
9 to 14
high
31.4-34.9%
15 to 21
very high
61.5-66.2%
Perfomance:
• The area under the ROC curve is around 0.77 but varies with ethnic group.
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