Analyzing the Performance of the COVID-19 Early Warning Score in Diagnosing COVID-19

<bold>Background:</bold> Early detection of COVID-19 is crucial for effective patient management and the control of COVID-19. The COVID-19 Early Warning Score (EWS) has been proposed as a potential tool for early diagnosis, yet its effectiveness remains under-investigated. <bold>Methods:</bold> This retrospective study analyzed data from 199 patients suspected of COVID-19 infection who were admitted to a hospital between October and December 2022. The sensitivity and specificity of the COVID-19 EWS in diagnosing COVID-19 were evaluated against RT-PCR test results, considered the gold standard. <bold>Results:</bold> The COVID-19 EWS score with a cutoff point of ≥10 had a significant correlation with SARS-CoV-2 PCR results and outcomes.(Table 1.) The COVID-19 EWS with a cutoff point of 7 demonstrated a sensitivity of 85% and a specificity of 90% in diagnosing COVID-19.(Table 2.) The area under ROC curve was 0.865, indicating high diagnostic accuracy. (Fig. 1) <table-wrap><object-id>erj;64/suppl_68/PA1495/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td>Characteristics</td><td> EWS</td><td></td><td>p- value</td></tr><tr><td></td><td>≥ 10</td><td>< 10</td><td></td></tr><tr><td>COVID-19</td><td></td><td></td><td>0.000</td></tr><tr><td>Positive</td><td>18 (9%)</td><td>33 (16.6%)</td><td></td></tr><tr><td>Negative</td><td>9 (4.5%)</td><td>139 (69.8%)</td><td></td></tr><tr><td>Outcome</td><td></td><td></td><td>0.011</td></tr><tr><td>Not-survive</td><td>10 (5%)</td><td>25 (12.6%)</td><td></td></tr><tr><td>Survive</td><td>17 (8.5%)</td><td>147 (73.9%)</td><td></td></tr></tbody></table><table><colgroup><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td></td><td>Cut off</td><td>Sensitivity</td><td>Specificity</td></tr><tr><td>COVID-19</td><td>≥ 7</td><td>86%</td><td>74%</td></tr><tr><td></td><td>≥ 10</td><td>35%</td><td>94%</td></tr></tbody></table></table-wrap> Discussion: The findings suggest that the EWS is a reliable tool for the early diagnosis of COVID-19, with high sensitivity and specificity. The modified COVID-19 Early Warning Score (EWS), excluding CT scan evaluations, can act as a predictor for SARS-CoV-2 PCR outcomes with a threshold set at ≥7, indicating a positive likelihood. Its implementation could facilitate timely clinical decisions, especially in settings with limited access to RT-PCR testing.