Evaluation of the modified early warning score (MEWS) and triage early warning score (TREWS) for prognostic assessment of hospitalized COVID-19 patients in a tertiary care hospital.

BACKGROUND

Amid the overcrowding of healthcare services in Brazil, the early identification of critically ill COVID-19 patients becomes essential.

AIMS: This study aims to evaluate the ability of the Modified Early Warning Score (MEWS) and Triage Early Warning Score (TREWS) to predict severity and mortality in hospitalized COVID-19 patients.

METHODS

In this retrospective cohort study, patients hospitalized with COVID-19 at the Instituto de Infectologia Emílio Ribas (IIER) were included. MEWS and TREWS scores were calculated based on patients' vital signs at the time of admission to IIER.

RESULTS

The study included 579 patients, predominantly male (60.45%), with a mean age of 52.54 years. Comorbidities such as diabetes mellitus (23.32%) and systemic arterial hypertension (41.28%) were common. Most patients were not fully vaccinated against COVID-19 (65.46%). The estimated 14-day survival was 75.10% for patients with MEWS ≤ 3.5 at admission and 56.50% for those with MEWS > 3.5 at admission (p < 0.001). The 14-day survival for patients with a TREWS ≤ 7.5 was 78.00%, compared to 52.80% for those with a TREWS > 7.5 (p < 0.001). Each additional point in MEWS was associated with a 1.33-fold increase in the odds of ICU admission (p < 0.001) and 1.51-fold increase in the odds of death (p < 0.001). Each additional point in TREWS was associated with a 1.36-fold increase in ICU admission (p < 0.001) and 1.49-fold increase in death (p < 0.001).

CONCLUSIONS

Both scores demonstrated the ability to identify critically ill patients at the time of admission.