Hamostaseologie 2021; 41(S 01): S24
DOI: 10.1055/s-0041-1728126
Oral Communication
COVID-19

Derivation and Validation of a Predictive Score for Disease Worsening in Patients with COVID-19

G Gerotziafas
1   Thrombosis Center, Service d’Hématologie Biologique Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine Sorbonne Université, Sorbonne University, Paris
2   Research Group “Cancer, Haemostasis and Angiogenesis”, INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Sorbonne University, Paris
,
T Sergentanis
3   Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece, University of Athens, Athens
,
G Voiriot
4   Service de réanimation et USC médico-chirurgicale, Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine Sorbonne Université, Sorbonne University, Paris
,
L Lassel
5   Service des Maladies Infectieuses et Tropicales, Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine Sorbonne Université, Sorbonne University, Paris
,
C Papageorgiou
6   Service Anesthésie, Réanimation et Médecine Périopératoire, Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de médecine Sorbonne Université, Sorbonne University, Paris
,
A Elabbadi
4   Service de réanimation et USC médico-chirurgicale, Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine Sorbonne Université, Sorbonne University, Paris
,
M Turpin
4   Service de réanimation et USC médico-chirurgicale, Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine Sorbonne Université, Sorbonne University, Paris
,
P Vandreden
7   Clinical Research Department, Diagnostica Stago, Gennevilliers
2   Research Group “Cancer, Haemostasis and Angiogenesis”, INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Sorbonne University, Paris
,
L Papageorgiou
1   Thrombosis Center, Service d’Hématologie Biologique Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine Sorbonne Université, Sorbonne University, Paris
2   Research Group “Cancer, Haemostasis and Angiogenesis”, INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Sorbonne University, Paris
,
T Psaltopoulou
8   Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, University of Athens, Athens
,
E Terpos
8   Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, University of Athens, Athens
,
MA Dimopoulos
8   Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, University of Athens, Athens
,
A Parrot
9   Service de pneumologie, Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de médecine Sorbonne Université, Sorbonne University, Paris
,
J Cadranel
9   Service de pneumologie, Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de médecine Sorbonne Université, Sorbonne University, Paris
,
G Pialloux
5   Service des Maladies Infectieuses et Tropicales, Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine Sorbonne Université, Sorbonne University, Paris
,
I Elalamy
10   Thrombosis Center, Service d’Hématologie Biologique Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine Sorbonne Université, Sorbonne University, Paris
2   Research Group “Cancer, Haemostasis and Angiogenesis”, INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Sorbonne University, Paris
,
M Farto
› Author Affiliations
 

Objective The prospective observational study conducted at the COVID-19 center of Tenon University Hospital in Paris aimed to develop a risk assessment model (RAM) for early identification of COVID-19 patients at risk for worsening disease.

Material and Methods Patients with confirmed COVID-19 (n = 420) were devided in derivation (n = 300) and validation (n = 120) cohorts and stratified to those hospitalized at the conventional ward (C-group) and those with worsening disease (W-group). The study end point was disease worsening. All patients were routinely evaluated with full blood count, prothrombin time (PT), fibrinogen, D-Dimers, antithrombin and protein C activity. Data from the first hospitalization day at the conventional ward or the ICU were analyzed.

Results Obesity, hypertention, diabetes and male gender, increased fibrinogen and D-Dimers, thrombocytopenia, AT-deficiency, lymphopenia and compensated DIC-ISTH score ≥5 were significant risk factors for worsening disease. The COMPASS-COVID-19 risk assessment model (RAM) derived from multivariate analysis includes: obesity, gender, compensated DIC, hemoglobin, and lymphocyte count. The score has a very good discriminating capacity to stratify patients at high and low risk for worsening disease, with AUC value at 0.77, sensitivity 81 % and specificity 60 %. Application of the COMPASS-COVID-19 score at the validation cohort showed 96 % sensitivity and 45 % specificity.

Conclusion The COMPASS-COVID-19 score could serve as an accurate clinical decision tool for an easy identification of 80 % COVID-19 patients at risk for disease worsening leading to prompt application of compassionate treatments including antithrombotic agents.



Publication History

Article published online:
18 June 2021

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