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Research Article
Luca Galassi
Azienda Socio Sanitaria Territoriale Bergamo Est
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2580-1704
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This work is licensed under a CC BY 4.0 License. Read Full License
Aim: COVID-19 represented an important challenge to the Italian health care system (IHCS). Our main aim was to obtain evidence to support the use of modified national early warning score (m-NEWS) as an interdisciplinary, common and universal scoring scale to quickly recognize patients with a risk of clinical deterioration before admission and during hospitalization. As a secondary goal, we tried to find a score threshold that can be implemented in an optimal triaging protocol for an emergency setting where healthcare resources are overloaded as happened during COVID-19 pandemic.
Methods: We performed a retrospective observational study. We included in our study all patients treated for COVID-19 infection in surgical departments between 01 March 2020 and 16 April 2020. Patients with negative test results for SARS-COV2 were excluded. m-NEWS score was obtained twice a day. Patients’ m-NEWS scores were analyzed in order to verify the correlation between m-NEWS (at admission and m-NEWS variation 24h after admission) and outcome (positive outcome-survival, negative outcome- death or intensive care unit (ICU) transfer).
Results: We included a population based sample of 225 Sars Cov-2 infected patients. Overall, the average age at hospitalization was 71 (ranging from 40 to 95). 144 (64%) patients were males and 81 (36%) females. m-NEWS values lower or equal to 7 were associated to the majority of the "recovered" population (100/132 75,75%) and at the same time to the minority of the "non recovered" population (25/93 26,88%).
Conclusions: For our sample, age is statistically correlated to the outcome but a triage protocol based solely on this variable is less effective than m-NEWS, which showed to be a reliable and easy-to-use score for first patient evaluation. Our observations pave the way towards further studies aiming at optimizing territorial and community healthcare management protocols.
Keywords
EWS, COVID19, SCORE, RESPIRATORY FAILURE
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This preprint is under consideration at SN Comprehensive Clinical Medicine. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Luca Galassi
Azienda Socio Sanitaria Territoriale Bergamo Est
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2580-1704
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 20 Apr, 2021
No community comments so far
Reviewers invited
Invitations sent on 23 Apr, 2021
Editor assigned
On 10 Mar, 2021
First submitted
On 10 Mar, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Aim: COVID-19 represented an important challenge to the Italian health care system (IHCS). Our main aim was to obtain evidence to support the use of modified national early warning score (m-NEWS) as an interdisciplinary, common and universal scoring scale to quickly recognize patients with a risk of clinical deterioration before admission and during hospitalization. As a secondary goal, we tried to find a score threshold that can be implemented in an optimal triaging protocol for an emergency setting where healthcare resources are overloaded as happened during COVID-19 pandemic.
Methods: We performed a retrospective observational study. We included in our study all patients treated for COVID-19 infection in surgical departments between 01 March 2020 and 16 April 2020. Patients with negative test results for SARS-COV2 were excluded. m-NEWS score was obtained twice a day. Patients’ m-NEWS scores were analyzed in order to verify the correlation between m-NEWS (at admission and m-NEWS variation 24h after admission) and outcome (positive outcome-survival, negative outcome- death or intensive care unit (ICU) transfer).
Results: We included a population based sample of 225 Sars Cov-2 infected patients. Overall, the average age at hospitalization was 71 (ranging from 40 to 95). 144 (64%) patients were males and 81 (36%) females. m-NEWS values lower or equal to 7 were associated to the majority of the "recovered" population (100/132 75,75%) and at the same time to the minority of the "non recovered" population (25/93 26,88%).
Conclusions: For our sample, age is statistically correlated to the outcome but a triage protocol based solely on this variable is less effective than m-NEWS, which showed to be a reliable and easy-to-use score for first patient evaluation. Our observations pave the way towards further studies aiming at optimizing territorial and community healthcare management protocols.
Figure 1
Figure 2
Figure 3
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