Home > Journals > Minerva Medica > Past Issues > Minerva Medica 2021 February;112(1) > Minerva Medica 2021 February;112(1):118-23



To subscribe
Submit an article
Recommend to your librarian


Publication history
Cite this article as


ORIGINAL ARTICLE   Free accessfree

Minerva Medica 2021 February;112(1):118-23

DOI: 10.23736/S0026-4806.20.07074-3


language: English

Clinical stability and in-hospital mortality prediction in COVID-19 patients presenting to the Emergency Department

Francesco GAVELLI 1, 2 , Luigi M. CASTELLO 1, 2, Mattia BELLAN 1, 3, Danila AZZOLINA 4, Eyal HAYDEN 1, 3, Michela BELTRAME 1, 2, Alessandra GALBIATI 1, 2, Clara A. GARDINO 1, 2, Maria L. GASTALDELLO 1, 2, Francesca GIOLITTI 1, 2, Emanuela LABELLA 1, 2, Filippo PATRUCCO 1, 5, Pier P. SAINAGHI 1, 3, Gian C. AVANZI 1, 2

1 Department of Translational Medicine, Eastern Piedmont University, Novara, Italy; 2 Emergency Department, Maggiore della Carità University Hospital, Novara, Italy; 3 Unit of Internal Medicine and Immunohematology, Maggiore della Carità University Hospital, Novara, Italy; 4 Research Support Unit, Department of Translational Medicine, Eastern Piedmont University, Novara, Italy; 5 Department of Respiratory Diseases, Maggiore della Carità University Hospital, Eastern Piedmont University, Novara, Italy

BACKGROUND: The Novara-COVID score was developed to help the emergency physician to decide which Coronavirus disease (COVID) patient required hospitalization at Emergency Department (ED) presentation and to which intensity of care. We aimed at evaluating its prognostic role.
METHODS: We retrospectively collected data of COVID patients admitted to our ED between March 16 and April 22, 2020. The Novara-COVID score was systematically applied to all COVID patients since its introduction in clinical practice and adopted to decide patients’ destination. The ability of the Novara-COVID score to predict in-hospital clinical stability and in-hospital mortality were evaluated through multivariable logistic regression and cox regression hazard models, respectively.
RESULTS: Among the 480 COVID patients admitted to the ED, 338 were hospitalized: the Novara-COVID score was 0-1 in 49.7%, 2 in 24.6%, 3 in 15.4% and 4-5 in 10.3% of patients. Novara-COVID score values of 3 and 4-5 were associated with lower clinical stability with adjusted odds ratios of 0.28 (0.13-0.59) and 0.03 (0.01-0.12), respectively. When in-hospital mortality was evaluated, a significant difference emerged between scores of 0-1 and 2 vs. 3 and 4-5. In particular, the death adjusted hazard ratio for Novara-COVID scores of 3 and 4-5 were 2.6 (1.4-4.8) and 8.4 (4.7-15.2), respectively.
CONCLUSIONS: The Novara-COVID score reliably predicts in-hospital clinical instability and mortality of COVID patients at ED presentation. This tool allows the emergency physician to detect patients at higher risk of clinical deterioration, suggesting a more aggressive therapeutic management from the beginning.

KEY WORDS: Coronavirus; Severe acute respiratory syndrome coronavirus 2; Emergency medicine

top of page