National Early Warning Score 2 (NEWS2) to identify inpatient COVID-19 deterioration: a retrospective analysis

ABSTRACT Introduction We sought to provide the first report of use NEWS2 monitoring pre-emptively identify clinical deterioration within hospitalised COVID-19 patients. Methods Consecutive adult admissions with PCR-confirmed were included in this single-centre retrospective UK cohort study. analysed all electronic observations recorded 28 days admission until discharge or occurrence a serious event, defined as any following: initiation respiratory support, intensive care, end life in-hospital death. Results 133/296 (44.9%) patients experienced at least one event. ≥ 5 heralded event sensitivity 0.98 (95% CI 0.96–1.00), specificity 0.28 (0.21–0.35), positive predictive value (PPV) 0.53 (0.47–0.59), and negative (NPV) 0.96 (0.90–1.00). The NPV (but not PPV) exceeded that other early warning scores including Modified Early Warning Score (MEWS) (0.59 [0.52–0.66], p<0.001) quick Sepsis Related Organ Failure Assessment (qSOFA) score (0.58 [0.51–0.65], p<0.001). Conclusion Our results support sensitive method patients, albeit expense relatively high false-trigger rate.