Important scoring systems for assessing the severity of COVID-19 based on COVID-19-related deaths in Wuhan,China

Background:This study aimed to investigate the clinical characteristics of 21 deaths and evaluate potential factors affecting disease severity and mortality risk in patients with coronavirus disease(COVID-19).Methods:This retrospective analysis assessed clinical data of 21 patients who died owing to COVID-19.Disease severity and mortality risk were assessed using Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ);Sepsis-related Organ Failure Assessment(SOFA);multilobular infiltration,hypo-lymphocytosis,bacterial coinfection,smoking history,hypertension and age(MuLBSTA);and pneumonia severity index(PSI)scores.Results:The mean age of the patients was 66±14 years and 15(71.4%)patients were men.Sixteen(76.2%)patients had chronic medical illnesses.Twelve(57.1%)patients were overweight.Decreased lymphocyte proportions were observed in 17(81.0%)patients on admission.Elevated D-dimer levels were observed in 11(52.4%)patients,and the levels significantly increased when pneumonia deteriorated.The initial APACHE II and SOFA scores demonstrated that 18(85.7%)and 13(61.9%)patients,respectively,were in the middle-risk level.MuLBSTA and PSI scores after admission were associated with higher risks of mortality in 13(61.9%)patients.Most patients developed organ failure and subsequently died.Conclusions:Older,overweight,male patients with a history of chronic illnesses and continuously decreased lymphocyte proportions and increased D-dimer levels might have higher risks of death owing to COVID-19.The combination of general scoring(SOFA)and pneumonia-specific scoring(MuLBSTA and PSI)systems after admission might be sensitive in assessing the mortality risk of patients with COVID-19 who are in critical condition.