Evaluation of Risk Prediction Scores for Adults Hospitalized with COVID-19 in a Highly-vaccinated Population, Aotearoa New Zealand 2022

Overview

Journal IJID Reg

Specialty Infectious Diseases

Date 2024 Sep 16

PMID 39281192

Authors

Michael James Maze

Jonathan Williman

Rebekah Anstey

Emma Best

Hasan Bhally

Aliya Bryce

Catherina L Chang

Kevin Chen

Jack Dummer

Michael Epton

William R Good

Jennifer Goodson

Corina Grey

Kate Grimwade

Robert J Hancox

Redzuan Zarool Hassan

Thomas Hills

Sandra Hotu

Colin McArthur

Susan Morpeth

David R Murdoch

Fiona Elizabeth Pease

Romana Pylypchuk

Nigel Raymond

Stephen Ritchie

Deborah Ryan

Vanessa Selak

Malina Storer

Tony Walls

Rachel Webb

Conroy Wong

Karen Wright

Affiliations

Soon will be listed here.

Abstract

Objectives: COVID-19 severity prediction scores need further validation due to evolving COVID-19 illness. We evaluated existing COVID-19 risk prediction scores in Aotearoa New Zealand, including for Māori and Pacific peoples who have been inequitably affected by COVID-19.

Methods: We conducted a multicenter retrospective cohort study in adults hospitalized with COVID-19 from January to May 2022, including all Māori and Pacific patients, and every second non-Māori, non-Pacific (NMNP) patient to achieve equal analytic power by ethnic grouping. We assessed the accuracy of existing severity scores (4C Mortality, CURB-65, PRIEST, and VACO) to predict death in the hospital or within 28 days.

Results: Of 2319 patients, 582 (25.1%) identified as Māori, 914 (39.4%) as Pacific, and 862 (37.2%) as NMNP. There were 146 (6.3%, 95% confidence interval 5.4-7.4%) deaths, with a predicted probability of death higher than observed mortality for VACO (10.4%), modified PRIEST (15.1%) and 4C mortality (15.5%) scores, but lower for CURB-65 (4.5%). C-statistics (95% CI) of severity scores were: 4C mortality: Māori 0.82 (0.75, 0.88), Pacific 0.87 (0.83, 0.90), NMNP 0.90 (0.86, 0.93); CURB-65: Māori 0.83 (0.69, 0.92), Pacific 0.87 (0.82, 0.91), NMNP 0.86 (0.80, 0.91); modified PRIEST: Māori 0.85 (0.79, 0.90), Pacific 0.81 (0.76, 0.86), NMNP 0.83 (0.78, 0.87); and VACO: Māori 0.79 (0.75, 0.83), Pacific 0.71 (0.58, 0.82), NMNP 0.78 (0.73, 0.83).

Conclusions: Following re-calibration, existing risk prediction scores accurately predicted mortality.

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