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Liang and colleagues developed a risk prediction score, COVID-GRAM, to identify adults with COVID-19 at higher risk of intensive care stay, mechanical ventilation or death.1 This score had strong performance in Chinese cohorts and has been validated in multiple non-US cohorts, although with variation in its performance (C-statistic ranging from 0.64 to 0.91).1 2 It has yet to been studied in US populations.1 2 Differences in the US hospital practices and patient population may affect the applicability of COVID-GRAM to this population. Additionally, clinical rationale and prior studies suggest that CURB-65 may predict severe disease in COVID-19.3 We compare the performances of COVID-GRAM with CURB-65 for predicting critical illness in patients with COVID-19 in a US population.
This retrospective study included adult patients admitted to an academic medical centre in Boston Massachusetts with a diagnosis of COVID-19 between 1 January 2020 and 29 June 2020. Individuals with prior COVID-19 hospitalisations were excluded. Patients were followed until outcome occurrence or the end of hospitalisation (whichever came first). Demographic and clinical data, patient outcomes and variables used in COVID-GRAM and CURB-65 were obtained from the electronic health record. The primary outcome was critical illness—defined as a …
Handling editor Richard Body
Contributors RA, TSA, JPS, SJH conceptualised the idea. AM, AP, AA, NP, MD, TM, TL, NF were involved in data collection. RA was involved in data analytics. LN was involved in analytical planning and statistical guidance. JPS and SJH supervised the study. All authors were involved in drafting the manuscript, intellectual design and critical revision of the manuscript for intellectual content.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests TSA discloses consulting fees from Alosa Health.
Provenance and peer review Not commissioned; externally peer reviewed.
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