New online tool ‘can identify Covid patients at highest risk of deterioration’

An online tool that can identify Covid-19 patients who are at highest risk of deterioration is being made freely available to NHS doctors from Friday.

The new risk-stratification tool, developed by researchers from the UK Coronavirus Clinical Characterisation Consortium (known as ISARIC4C), assesses data collected from hospital patients along with some standard laboratory tests.

It then calculates a percentage risk of deterioration based on the information, which is known as the 4C Deterioration Score.

The new tool builds on the scientists’ previous work – the 4C Mortality Score – which predicts the percentage risk of death from Covid-19 after admission to hospital.

The researchers said their work, published in the journal The Lancet Respiratory Medicine, could help improve patient outcomes and may save lives.

Mahdad Noursadeghi, a professor of infectious diseases at University College London’s Faculty of Medical Sciences, who is a co-senior author on the paper, said: “Accurate risk-stratification at the point of admission to hospital will give doctors greater confidence about clinical decisions and planning ahead for the needs of individual patients.

“The addition of the new 4C Deterioration Score alongside the 4C Mortality Score will provide clinicians with an evidence-based measure to identify those who will need increased hospital support during their admission, even if they have a low risk of death.”

To develop their online tool, researchers used data from 74,944 adults with Covid-19 who were admitted to 260 hospitals across England, Scotland and Wales, between February 6 and August 26 2020.

They said it can be incorporated into NHS trusts’ Electronic Health Record System – used to manage all patient care – so that risk scores for patients can be generated automatically.

First author Dr Rishi Gupta, of UCL’s Institute of Global Health, said: “The scale and wide geographical coverage of the ISARIC4C study across the country was critical to the development of this prediction tool.

“Our analysis provides very encouraging evidence that the 4C Deterioration tool is likely to be useful for clinicians across England, Scotland and Wales to support clinical decision-making.”