Objective: Researchers have been investigating numerous biomarkers and scoring systems to predict the prognosis of coronavirus disease 2019 (COVID-19). We aimed to determine the effectiveness of the quick sequential organ failure assessment (qSOFA) scoring system in pre-hospital emergency health care for predicting COVID-19 prognosis in terms of the intensive care unit (ICU) admission and mortality.
Materials and Methods: We enrolled 9850 patients suspected to have COVID-19 who were transferred by 112 emergency medical services (EMS) between April 1, 2020 and July 1, 2020. Demographic and clinical data of the patients were obtained from the Ankara Emergency Health Services Automation System. The qSOFA score was calculated based on the data obtained from the ambulance medical records.
Results: The 28-day mortality rate was 6.2% (n=13) and the cut-off for the qSOFA score was >1 [area under the curve (AUC)=0.955, sensitivity 84.62%, specificity 90.4%, p<0.001, 95% confidence interval (CI): 0.918–0.979)]. The cut-off for ICU admission was a qSOFA score >1 (AUC=0.942; sensitivity 97.37%; specificity 84.97%; p<0.001; 95% CI, 0.901–0.969). The mortality risk was 51.8 times more in patients with a high qSOFA score (p<0.001; 95% CI, 10.682–251.340). Moreover, patients with a high qSOFA score were 47.7 times more likely to require ICU admission (p<0.001; 95% CI, 16.735–136.039).
Conclusion: Thus, the pre-hospital qSOFA score that comprises the ambulance vital signs of the patients can be used to predict ICU admissions and mortality in patients with COVID-19.