The low‐harm score for predicting mortality in patients diagnosed with COVID‐19: A multicentric validation study
Adrián Soto-Mota, Braulio A. Marfil‐Garza, Erick Martínez Rodríguez, José Omar Barreto Rodríguez, Alicia Estela López Romo, Paolo Alberti‐Minutti, Juan Vicente Alejandre Loya, Félix Emmanuel Pérez Talavera, Freddy José Ávila Cervera, Adriana Velazquez Burciaga, Oscar Morado Aramburo, Luis Alberto Piña Olguín, Adrian Soto‐Rodríguez, Andrés Castañeda Prado, Patricio Santillán‐Doherty, Juan O Galindo Galindo, Luis Alberto Guízar García, Daniel Hernández Gordillo, Juan Gutiérrez Mejía
Abstract
Objective: We sought to determine the accuracy of the LOW-HARM score (Lymphopenia, Oxygen saturation, White blood cells, Hypertension, Age, Renal injury, and Myocardial injury) for predicting death from coronavirus disease 2019) COVID-19. Methods: We derived the score as a concatenated Fagan's nomogram for Bayes theorem using data from published cohorts of patients with COVID-19. We validated the score on 400 consecutive COVID-19 hospital admissions (200 deaths and 200 survivors) from 12 hospitals in Mexico. We determined the sensitivity, specificity, and predictive values of LOW-HARM for predicting hospital death. Results: LOW-HARM scores and their distributions were significantly lower in patients who were discharged compared to those who died during their hospitalization 5 (SD: 14) versus 70 (SD: 28). The overall area under the curve for the LOW-HARM score was 0.96, (95% confidence interval: 0.94-0.98). A cutoff > 65 points had a specificity of 97.5% and a positive predictive value of 96%. Conclusions: The LOW-HARM score measured at hospital admission is highly specific and clinically useful for predicting mortality in patients with COVID-19.