Development of a Severity Assessment score for COVID-19: COVID Severity Score (CSS) at the time of admission to Hospital.

Background: As of mid-2022, more than 650 million people have been infected with COVID-19 worldwide. With ongoing outbreaks and varying degrees of severity in different regions of the globe, we continue to battle against this global health crisis after 3 years of discovery of Sars-CoV-2. It is crucial for clinicians to utilize the information collected over this time period to combat any upcoming wave in the future. One approach to this is the development of a scoring system that can assess the severity of COVID-19 patients at the time of admission. Although much is known about the course of its clinical disease, much more is yet to be discovered in terms of its optimal management to yield favorable outcomes. Recognizing key risk factors and biochemical parameters can assist in an early assessment of the severity of COVID-19, thus leading to a timely management reducing morbidity and mortality. Objective: To predict the extent of COVID-19 disease severity upon admission using readily available means of assessment in a city with a lower socioeconomic status. Methodology: This retrospective analysis was conducted at the Department of Pulmonology, Dr. Ziauddin University Hospital in Karachi. The study spanned from June 2021 to June 2022. A total of 102 patient records were included in this research. These patients had tested positive for SARS-CoV-2, either through a reverse transcription polymerase chain reaction (RT-PCR) test or a rapid antigen detection test. Data for this study was collected from electronic medical records (EMR) and chart reviews, and the analysis was performed using SPSS version 26.0. Results: The COVID-19 Severity Score (CSS) is a cumulative score derived from nine parameters and was developed by closely observing 102 COVID-19 patients. Parameters incorporated are Age, Comorbidities, Ferritin, LDH, D-dimer, Neutrophil to Lymphocyte Ratio (NLR), Chest X-ray, Creatinine, and Platelet Count. Each parameter is assigned a score according to predefined cutoff ranges, which include a semiquantitative method for interpreting chest X-rays. A patient's total score is calculated by summing individual parameter scores, with a maximum possible score of 29. The CSS grading system categorizes patients into four "severity risk" groups. The study assessed the CSS's effectiveness in predicting the risk of severe COVID-19 by considering four key factors: hospital stay duration, need for mechanical ventilation, oxygen requirements, and mortality at discharge. Conclusion: In conclusion, this study's findings strongly advocate for the use of CSS scores as a valuable tool in risk stratification for severe COVID-19 cases. Early identification of patients with high CSS scores should prompt intensified medical care, including extended hospital stays, mechanical ventilation, and oxygen support, to improve patient outcomes and reduce mortality in this vulnerable population. [ABSTRACT FROM AUTHOR]