National Early Warning Score 2 (NEWS2) to identify inpatient COVID-19 deterioration: a retrospective analysis

Article Figures & Data

Table 1.

Cohort clinical characteristics, stratified by occurrence of serious event

Demographic	N	Cohort (n=296)	Any event (n=133)	No event (n=163)	p
Male sex	296	162 (54.7)	76 (57.1)	86 (52.8)	0.524
Age (years)	296	75 (62–84) [23–101]	76 (63–84) [32–97]	74 (60–83) [23–101]	0.132
Symptom duration at admission (days)	296	4 (2–9) [0–42]	5 (2–9) [0–21]	4 (2–9) [0–42]	0.386
Clinical frailty score	294	4 (2–6) [1–9]	5 (2–6) [1–9]	4 (2–6) [1–7]	0.103
Nursing / residential home	296	60 (20.3)	33 (24.8)	27 (16.6)	0.107
WHO severe COVID-19 at admission	293	131 (44.7)	86 / 131 (65.6)	45 / 162 (27.7)	<0.001
CURB-65 score at admission	287	2 (1–2) (0–4)	2 (1–3) [0–4]	1 (1–2) [0–4]	0.003
Pneumonia on admission chest radiograph	288	114 (39.6)	71 / 132 (53.8)	43 / 156 (27.6)	0.004
Cumulative admission duration (days)	296	8 (4–14) [0–28]	9 (5–18) [0–28]	8 (3–12) [0–28]	0.011
Baseline NEWS2 score	296	5 (2–7) [0–16]	6 (4–8) [0–16]	3 (2–5) [0–11]	<0.001
Baseline MEWS score	296	2 (1–3) [0–9]	3 (2–4) [0–9]	2 (1–3) [0–9]	<0.001
Baseline qSOFA score	296	1 (0–1) [0–3]	1 (0–1) [0–3]	0 (0–1) [0–2]	<0.001

Data are median (IQR) [range] for continuous variables, and n (%) or n/N (%) for categorical variables.

Table 2.

Diagnostic metrics of NEWS2, MEWS and qSOFA score triggers for serious event within 24 hours

Metric	NEWS2	MEWS	qSOFA
Sensitivity	0.98 (0.96–1.00)	0.39 (0.31–0.47)^*	0.32 (0.24–0.39)^*
Specificity	0.28 (0.21–0.35)	0.71 (0.64–0.78)^*	0.77 (0.71–0.84)^*
Positive predictive value	0.53 (0.47–0.59)	0.53 (0.43–0.62)^ns	0.53 (0.42–0.64)^ns
Negative predictive value	0.96 (0.90–1.00)	0.59 (0.52–0.66)^*	0.58 (0.51–0.65)^*
Positive likelihood ratio	1.37 (1.24–1.51)	1.36 (0.98–1.87)^ns	1.39 (0.95–2.03)^ns
Negative likelihood ratio	0.05 (0.01–0.22)	0.86 (0.72–1.01)^*	0.89 (0.77–1.02)^*