Development and Validation of a New Risk Score for Infection with Coronavirus (Ri.S.I.Co) Obtained from Treating Coronavirus Disease (COVID-19) Patients on the Field
نویسندگان
1 General and Emergency Surgery Department, Bufalini Hospital, Cesena, Italy
2 General and Emergency Surgery Department, Bufalini Hospital, Cesena, Italy
3 General and Emergency Surgery Department, Bufalini Hospital, Cesena, Italy
4 General and Emergency Surgery Department, Bufalini Hospital, Cesena, Italy
5 Intensive Care Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
6 Emergency Surgery Unit, State University of Pisa, Cisanello Hospital, Pisa, Italy
7 General and Emergency Surgery Department, Bufalini Hospital, Cesena, Italy
8 General and Emergency Surgery Department, Bufalini Hospital, Cesena, Italy
9 General and Emergency Surgery Department, Bufalini Hospital, Cesena, Italy
10 Internal Medicine Unit, Bufalini Hospital, Cesena, Italy
11 Intensive Care Unit, Bufalini Hospital, Cesena, Italy
12 General and Emergency Surgery Department, Bufalini Hospital, Cesena, Italy
doi
چکیده
Background: The Coronavirus Disease 2019 (COVID-19) pandemic has necessitated the alteration of the organization of entire hos- pitals to try to prevent them from becoming epidemiological clusters. The adopted diagnostic tools lack sensitivity or specificity. Objectives: The aim of the study was to create an easy-to-get risk score (Ri.S.I.Co., risk score for infection with the new coronavirus) developed on the field to stratify patients admitted to hospitals according to their risk of COVID-19 infection. Methods: In this prospective study, we included all patients who were consecutively admitted to the suspected COVID-19 depart- ment of the Bufalini Hospital, Cesena (Italy). All clinical, radiological, and laboratory predictors were included in the multivariate logistic regression model to create a risk model. A simplified model was internally and externally validated, and two score thresh- olds for stratifying the probability of COVID-19 infection were introduced. Results: From 11th March to 5th April 2020, 200 patients were consecutively admitted. A Ri.S.I.Co lower than 2 showed a higher sensitivity than SARS-Cov-2 nucleic acid detection (96.2% vs. 65.4%; P < 0.001). The presence of ground-glass pattern on the lung-CT scan had a lower sensitivity than a Ri.S.I.Co lower than 2 (88.5% vs. 96.2%; P < 0.001) and a lower specificity than a Ri.S.I.Co higher than 6 (75.0% vs. 96.9%; P < 0.001). Conclusions: We believe that the Ri.S.I.Co could allow to stratify admitted patients according to their risk, preventing hospitals from becoming the main COVID-19 carriers themselves. Furthermore, it could guide clinicians in starting therapies early in severe- onset cases with a high probability of COVID-19, before molecular SARS-CoV-2 infection is confirmed.
