Intubated COVID-19 predictive (ICOP) score for early mortality after intubation in patients with COVID-19

Sci Rep. 2021 Oct 26;11(1):21124. doi: 10.1038/s41598-021-00591-1.

Abstract

Patients with coronavirus disease 2019 (COVID-19) can have increased risk of mortality shortly after intubation. The aim of this study is to develop a model using predictors of early mortality after intubation from COVID-19. A retrospective study of 1945 intubated patients with COVID-19 admitted to 12 Northwell hospitals in the greater New York City area was performed. Logistic regression model using backward selection was applied. This study evaluated predictors of 14-day mortality after intubation for COVID-19 patients. The predictors of mortality within 14 days after intubation included older age, history of chronic kidney disease, lower mean arterial pressure or increased dose of required vasopressors, higher urea nitrogen level, higher ferritin, higher oxygen index, and abnormal pH levels. We developed and externally validated an intubated COVID-19 predictive score (ICOP). The area under the receiver operating characteristic curve was 0.75 (95% CI 0.73-0.78) in the derivation cohort and 0.71 (95% CI 0.67-0.75) in the validation cohort; both were significantly greater than corresponding values for sequential organ failure assessment (SOFA) or CURB-65 scores. The externally validated predictive score may help clinicians estimate early mortality risk after intubation and provide guidance for deciding the most effective patient therapies.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Arterial Pressure
  • COVID-19 / diagnosis*
  • COVID-19 / mortality*
  • COVID-19 / therapy
  • Female
  • Ferritins / blood
  • Humans
  • Hydrogen-Ion Concentration
  • Intubation, Intratracheal / methods*
  • Male
  • Middle Aged
  • New York
  • Nitrogen / metabolism
  • Oxygen / metabolism
  • Predictive Value of Tests
  • ROC Curve
  • Regression Analysis
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index*
  • Vasoconstrictor Agents / pharmacology
  • Young Adult

Substances

  • Vasoconstrictor Agents
  • Ferritins
  • Nitrogen
  • Oxygen