New Tools May Identify COVID Patients at Highest Risk of Mechanical Ventilation and of Death; May Permit Better Allocation of Scarce Resources

Two novel calculators for predicting which patients admitted to the hospital with COVID-19 are at greatest risk of requiring mechanical ventilation or of in-hospital death have been developed and validated by Massachusetts General Hospital (MGH). In a study published in the March 2021 issue The Lancet's EClinicalMedicine (https://www.sciencedirect.com/science/article/pii/S2589537021000456), researchers describe how these models could enable clinicians to better stratify risk in COVID-infected patients to optimize care and resource utilization in hospitals faced with ICU capacity constraints. The open-access article is titled “Estimating Risk of Mechanical Ventilation and In-Hospital Mortality Among Adult COVID-19 patients Admitted to Mass General Brigham: The VICE and DICE Scores.” "Information that can accurately predict severity of the clinical course at the time of hospital admission has been limited," says senior author Rajeev Malhotra, MD, a cardiologist at MGH and investigator in the MGH Cardiovascular Research Center. "Using a combination of past medical history, vital signs, and laboratory results at the time of patient admission, we developed models that can differentiate between risk for mechanical ventilation and risk for in-hospital mortality. While other studies have focused on 30-day hospital outcomes, we followed all COVID-19 patients to the end of their hospital course because a significant number are hospitalized well beyond 30 days." The research team compiled this clinical information from 1,042 patients confirmed with COVID-19 who were admitted to five hospitals in the Mass General Brigham health care system during the first three months of the pandemic.
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