Dickens et al reported the "Rule-of-6" for identification of a patient with severe COVID-19 infection. This can help to identify a patient who will require more aggressive management. The authors are from the National University of Singapore and National University Hospital.
Patient selection: COVID-19
Parameters from the first 48 hours:
(1) serum ferritin in µg/L
(2) serum LDH in U/L
(3) serum CRP in mg/L
Parameter
Finding
Points
serum ferritin
<= 600 µg/L
0
> 600 µg/L
1
serum LDH
<= 600 U/L
0
> 600 U/L
1
serum CRP
<= 60 mg/L
0
> 60 mg/L
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
ICU Patient
AUC
age
0.84
serum ferritin
0.90
serum CRP
0.93
serum LDH
0.86
Additional factors associated with severe disease:
(1) need for supplemental oxygen
(2) intubation
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