In a new study, researchers found people who are admitted to hospital with COVID-19 can be divided into four distinct groups.
They identified the groups using clinical information and tests carried out upon arrival at the hospital to predict the patients’ risk of death—ranging from low to very high.
The research was conducted by a team from the University of Edinburgh and elsewhere.
A COVID-19 risk identification tool—the most accurate to date—has been designed using the groupings to help clinical staff choose the best course of treatment for patients admitted to the hospital.
The tool was built with data from some 35,000 patients admitted to hospital between February and May 2020 who met the criteria for one of the four groups.
It was then tested and confirmed to be accurate using data from a further 22,000 patients hospitalized from the end of May to the end of June 2020.
Some of the data used to identify which group a person falls into—and, therefore, their risk of dying—included age, sex, the number of pre-existing conditions, the respiratory rate on admission, and the results of two blood tests.
One in every hundred patients in the low-risk group was found to be at risk of dying. It was 10 in a hundred patients in the intermediate-risk group, 31 in a hundred in the high-risk group, and 62 in a hundred in the very high-risk group.
The team says the categorizations make new treatment pathways possible.
For example, it might be more appropriate for those who fall into the low-risk subgroup to be treated at home.
In contrast, people in the high or very high-risk groups could benefit from more aggressive treatment, such as the use of antivirals and early admission to critical care.
Until now there has not been an accurate risk tool for COVID-19 patients. Existing tools for pneumonia or sepsis do not offer accurate predictions due to the differences between diseases.
Previous attempts to build a risk prediction tool for COVID-19 have had limited success due to small sample sizes and lack of formal validation.
One limitation of this new tool, however, is that it can only be used on hospital patients and not within the community.
One author of the study is Professor Ewen Harrison.
The study is published in the BMJ.
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