Development of a risk score to identify patients at high risk for a severe course of COVID-19

Abstract

Aim:

We aimed to develop a risk score to calculate a person’s individual risk for a severe COVID-19 course (POINTED score) to support prioritization of especially vulnerable patients for a (booster) vaccination. Subject and methods:

This cohort study was based on German claims data and included 623,363 individuals with a COVID-19 diagnosis in 2020. The outcome was COVID-19 related treatment in an intensive care unit, mechanical ventilation, or death after a COVID-19 infection. Data were split into a training and a test sample. Poisson regression models with robust standard errors including 35 predefined risk factors were calculated. Coefficients were rescaled with a min–max normalization to derive numeric score values between 0 and 20 for each risk factor. The scores’ discriminatory ability was evaluated by calculating the area under the curve (AUC). Results:

Besides age, down syndrome and hematologic cancer with therapy, immunosuppressive therapy, and other neurological conditions were the risk factors with the highest risk for a severe COVID-19 course. The AUC of the POINTED score was 0.889, indicating very good predictive validity. Conclusion:

The POINTED score is a valid tool to calculate a person’s risk for a severe COVID-19 course.