4C Mortality Score and CT Severity Score among COVID-19 Patients; A Single Center Prospective Study

Abstract Background Predictions about the hospital course of the coronavirus disease 2019 (COVID-19) patients are of paramount value. Objectives This research was designed to validate 4C mortality and CT severity scores (CT-SS) and detect their relations among patients with covid-19 who are hospitalized as prognostication tools. Patients and methods Two hundred and ninety-six confirmed COVID-19 cases were included. They were allocated into 3 groups according to severity;78 in non-severe group, 97 in severe group, and 121 patients in critical group. Patient demographics, clinical characteristics, co-morbidities, lines of treatment, 4C mortality score and CT severity score were assessed upon admission. Results The study revealed that 90% and 84.3% sensitivities were observed for both of 4C mortality and CT-SS respectively as predictors of mortality. Significant correlation between both scores (r = 0.6. p = 0.0001) was detected. Multivariate analysis identified 7-fold increased risk of mortality for the patients with 4C mortality score > 9.5 (p = 0.001). CT-SS > 12 (p = 0.02), age ≥ 60, male gender, hypertension and diabetes mellitus were also found as significant independent factors associated with increased mortality. Conclusion Satisfactory results were found on addition a verified radiological score to commonly used risk-stratification scores when estimating the probability of death in severe and critical cases in COVID-19.