During this pandemic period, the goal of the health care system is to optimize the use of intensive care services for patients infected with SARS-CoV-2, given the frequency of complications that can lead to high mortality. When patients with suspected or confirmed COVID-19 are admitted to hospital, whether or not they are symptomatic, there is currently no method to predict who will progress to complications requiring the use of intensive measures in 24-48 hours.
The body undergoes a systemic adaptation response to severe illness. Elevated cortisol and
systemic inflammation are two key responses. Along with hypotension, this triad can lead to
end-organ failure and death in critical illness. In critical illness, serum cortisol is
dissociated from its tissular activity. We have developed a formula that calculates tissular
action of cortisol called the cortisol index. It correlates in chronic ambulatory illness,
and acute illness such as myocardial infarction (manuscript pending). Elevated neutrophil to
lymphocyte ration (NLR) is a marker of systemic inflammation and predictor of mortality on
admission to the emergency department. We have confirmed this in a retrospective and
prospective study (manuscript pending, data available upon request).
The purpose of this study is to evaluate a triage score (STC-19) based on patients'
biological state at the time of diagnosis, to objectively determine which patients are most
likely to require intensive medical services within 24-48 hours of presentation of the
emergency department.
Diagnostic Test: STC-19 score
Score calculated by an algorithm using a vital sign (systolic blood pressure) and biomarkers (complete blood count with differential)
Inclusion Criteria:
- Patient with clinical signs of CoV-2-SARS infection
- Complete blood count test and systolic blood pressure available at the time of
diagnosis
- Informed of the study.
Exclusion Criteria:
- Women beyond the 1st trimester of pregnancy
- Persons under-the-age-of or legally-denied medical decision-making capacity by a
judicial or administrative decision,
- Persons of full age who are subject to a legal protection measure,
- Persons unable to consent,
- Persons who are not members of or beneficiaries of a social welfare program
administered by the Republic of France
- Patient's refusal to participate in the study.
Groupe Hospitalier de la Rochelle Ré Aunis
La Rochelle, France