ISSN: 0034-8376
eISSN: 2564-8896






Development of Simple and Sensitive Score to Assess the Risk of Pneumonia in COVID-19 Patients



Macarena Hormanstorfer, Division of Internal Medicine, Hospital Juan A. Fernández, Buenos Aires, Argentina
Martin A. Ragusa, Division of Internal Medicine, Hospital Juan A. Fernández, Buenos Aires, Argentina
Lucia Poggio, Division of Internal Medicine, Hospital Juan A. Fernández, Buenos Aires, Argentina
Jorge Moreira-Facundo, Division of Internal Medicine, Hospital Juan A. Fernández, Buenos Aires, Argentina
Zulma Orellana-Villa, Division of Internal Medicine, Hospital Juan A. Fernández, Buenos Aires, Argentina
Florencia A. Bobrowski, Division of Internal Medicine, Hospital Juan A. Fernández, Buenos Aires, Argentina
Joaquin Martinez-Serventi, Division of Internal Medicine, Hospital Juan A. Fernández, Buenos Aires, Argentina
Santiago N. Piombi-Adanza, Division of Internal Medicine, Hospital Juan A. Fernández, Buenos Aires, Argentina
Jose A. Enrique-Barletta, Division of Infectious Diseases, Hospital Juan A. Fernández, Buenos Aires, Argentina
Alicia Sisto, Division of Infectious Diseases, Hospital Juan A. Fernández, Buenos Aires, Argentina
Hugo Delle-Piane, Division of Internal Medicine, Hospital Juan A. Fernández, Buenos Aires, Argentina
Juan M. Carrillo, Division of Internal Medicine, Hospital Juan A. Fernández, Buenos Aires, Argentina
Jose L. Presas, Division of Internal Medicine, Hospital Juan A. Fernández, Buenos Aires, Argentina
Francisco Paulin, Interstitial Lung Disease Clinic, Hospital María Ferrer, Buenos Aires, Argentina


Background: Severe pneumonia is the most common cause of intensive care unit (ICU) admission and death due to novel coronavirus (SARS-CoV-2) respiratory disease (COVID-19). Due to its rapid outbreak, units for the evaluation of febrile patients in the pre-hospital setting were created. Objective: The objective of the study was to develop a sensitive and simple tool to assess the risk of pneumonia in COVID-19 patients and thus select which patients would require a chest imaging study. Materials and Methods: We conducted a cross-sectional study in a cohort of individuals with suspected COVID-19 evaluated in a public academic healthcare center in Buenos Aires city. All adult patients with positive RT-PCR assay for SARS-COV2 between April 24 and May 19 of 2020 were included in the study. Pneumonia was defined as the presence of compatible signs and symptoms with imaging confirmation. Univariate and multivariate logistic regression was performed. A risk indicator score was developed. Results: One hundred and forty-eight patients were included, 71 (48%) received the diagnosis of pneumonia. The final clinical model included four variables: age >-40 years, cough, absence of sore throat, and respiratory rate >- 22. To create the score, we assigned values to the variables according to their ORs: 2 points for respiratory rate >- 22 and 1 point to the other variables. The AUC of the ROC curve was 0.80 (CI 95% 0.73-0.86). A cutoff value of 2 showed a sensitivity of 95.7% and a specificity of 43.24%. Conclusion: This sensible score may improve the risk stratification of COVID-19 patients in the pre-hospital setting.



Keywords: COVID-19. SARS-CoV-2. Pneumonia. Risk indicator score.