Prognostic risk scores for hospitalized COVID-19 patients during the omicron period

Aim: During the COVID-19 pandemic, as the number of cases and deaths increased various algorithms were started to used to facilitate patient management. This study aimed to assess the usefulness of the CALL, CHOSEN, HA2T2, and ANDC scores in prognostic assessment and to investigate the establishment of a new scoring system, referred to as CoNTroLAC. Materials and methods: We retrospectively analyzed hospitalized COVID-19 patients. Demographic and laboratory parameters, including comorbidity status, neutrophil-to-lymphocyte ratio (NLR), troponin, LDH, age, and CRP, were assessed in relation to mortality. Mortality distributions across CALL, HA₂T₂, and ANDC risk groups were compared with original reports. A new prognostic score, CoNTroLAC, was constructed using six admission-based parameters using ROC analysis. Results: Mortality was significantly associated with comorbidities, high NLR, elevated troponin, increased LDH, older age, and CRP >10 µg/mL. CALL, HA₂T₂, and ANDC scores demonstrated mortality stratification consistent with findings in their original cohorts. CoNTroLAC, integrating these six parameters, achieved excellent prognostic performance with an AUROC of 0.915. A cut-off score of 12.5 yielded 82.9% sensitivity and 84.7% specificity. Conclusion: In our Omicron-era cohort, CALL, HA₂T₂, and ANDC scores retained prognostic validity comparable to their original derivation studies. The newly developed CoNTroLAC score, incorporating comorbidity, NLR, troponin, LDH, age, and CRP, demonstrated excellent discrimination and may provide a simple, practical tool for early mortality risk stratification in hospitalized COVID-19 patients.