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New online tool can predict deterioration in COVID-19 patients

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The findings were published in The Lancet Respiratory Medicine 

A new online tool has been developed by researchers from the UK Coronavirus Clinical Characterisation Consortium (ISARIC4C) which can predict the likelihood of deterioration in adults hospitalised with COVID-19.

ISARIC4C was funded as part of a joint rapid research response by UK Research and Innovation and the Department of Health and Social Care through the National Institute for Health Research (NIHR).

Researchers – whose findings were published in The Lancet Respiratory Medicine – say the online tool, made freely available to NHS doctors, could support clinicians’ decision making – helping to improve patient outcomes and ultimately save lives.

The tool assesses 11 measurements routinely collected from patients, including age, gender, and physical measurements, along with some standard laboratory tests. It calculates a percentage risk of deterioration, known as the 4C Deterioration Score.

Professor Mahdad Noursadeghi, co-senior and corresponding author, said: “Accurate risk-stratification at the point of admission to hospital will give doctors greater confidence about clinical decisions and planning ahead for the needs of individual patients.

“The addition of the new 4C deterioration score, alongside the 4C mortality score, will provide clinicians with an evidence-based measure to identify those who will need increased hospital support during their admission, even if they have a low risk of death.”

The tool was developed using data from 74,944 individuals with COVID-19 admitted to 260 hospitals across England, Scotland and Wales between 6 February and 26 August 2020.

Researchers assessed how well the tool performed in nine NHS regions and found that it performed similarly well in each.

First author Dr Rishi Gupta, UCL Institute of Global Health, said: “The scale and wide geographical coverage of the ISARIC4C study across the country was critical to the development of this prediction tool.

“Our analysis provides very encouraging evidence that the 4C Deterioration tool is likely to be useful for clinicians across England, Scotland and Wales to support clinical decision-making.”

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