ArticleBMJ open2021
Use of the first National Early Warning Score recorded within 24 hours of admission to estimate the risk of in-hospital mortality in unplanned COVID-19 patients: a retrospective cohort study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Does the use of National Early Warning Scores (NEWS or NEWS2) in healthcare settings improve patient outcomes: a systematic review.Systematic reviews · 2026Pooled it
- The Prognostic Accuracy of National Early Warning Score 2 on Predicting Clinical Deterioration for Patients With COVID-19: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2021Pooled it
- Article
- Predicting COVID-19 Patient Disposition Using the National Early Warning Score 2: A Retrospective Cohort Study.Cureus · 2025Article
- The association between vital signs at hospital admission and adverse outcomes in patients with COVID-19: a retrospective cohort study.Frontiers in medicine · 2025Article
- Personalized Assessment of Mortality Risk and Hospital Stay Duration in Hospitalized Patients with COVID-19 Treated with Remdesivir: A Machine Learning Approach.Journal of clinical medicine · 2024Article
- Article
- Sociodemographic, clinical and laboratory characteristics and risk factors for mortality of hospitalized COVID-19 patients at alternate care site: a Latin American experience.Annals of medicine · 2023Article
- Gene Expression Risk Scores for COVID-19 Illness Severity.The Journal of infectious diseases · 2023Article
- The accuracy of the National Early Warning Score 2 in predicting early death in prehospital and emergency department settings: a systematic review and meta-analysis.Annals of translational medicine · 2023Article
- One-on-one comparison between qCSI and NEWS scores for mortality risk assessment in patients with COVID-19.Annals of medicine · 2022Article
- Comorbidity-adjusted NEWS predicts mortality in suspected patients with COVID-19 from nursing homes: Multicentre retrospective cohort study.Journal of advanced nursing · 2022Article
- Observational
- National early warning score (NEWS) 2 predicts hospital mortality from COVID-19 patients.Annals of medicine and surgery (2012) · 2022Article
- COVID-19 disease in hospitalized young adults in India and China: Evaluation of risk factors predicting progression across two major ethnic groups.Journal of medical virology · 2022Observational
- Predictive Value of an Age-Based Modification of the National Early Warning System in Hospitalized Patients With COVID-19.Open forum infectious diseases · 2021Article
- Modified PRIEST score for identification of very low-risk COVID patients.The American journal of emergency medicine · 2021Article
- Gene Expression Risk Scores for COVID-19 Illness Severity.bioRxiv : the preprint server for biology · 2021Article
- Performance Analysis of the National Early Warning Score and Modified Early Warning Score in the Adaptive COVID-19 Treatment Trial Cohort.Critical care explorations · 2021Article
- National Early Warning Score 2 (NEWS2) to predict poor outcome in hospitalised COVID-19 patients in India.PloS one · 2021Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAlthough the National Early Warning Score (NEWS) and its latest version NEWS2 are recommended for monitoring deterioration in patients admitted to hospital, little is known about their performance in COVID-19 patients. We aimed to compare the performance of the NEWS and NEWS2 in patients with COVID-19 versus those without during the first phase of the pandemic.
designA retrospective cross-sectional study.
settingTwo acute hospitals (Scarborough and York) are combined into a single dataset and analysed collectively.
participantsAdult (≥18 years) non-elective admissions discharged between 11 March 2020 and 13 June 2020 with an index or on-admission NEWS2 electronically recorded within ±24 hours of admission to predict mortality at four time points (in-hospital, 24 hours, 48 hours and 72 hours) in COVID-19 versus non-COVID-19 admissions.
resultsOut of 6480 non-elective admissions, 620 (9.6%) had a diagnosis of COVID-19. They were older (73.3 vs 67.7 years), more often male (54.7% vs 50.1%), had higher index NEWS (4 vs 2.5) and NEWS2 (4.6 vs 2.8) scores and higher in-hospital mortality (32.1% vs 5.8%). The c-statistics for predicting in-hospital mortality in COVID-19 admissions was significantly lower using NEWS (0.64 vs 0.74) or NEWS2 (0.64 vs 0.74), however, these differences reduced at 72hours (NEWS: 0.75 vs 0.81; NEWS2: 0.71 vs 0.81), 48 hours (NEWS: 0.78 vs 0.81; NEWS2: 0.76 vs 0.82) and 24hours (NEWS: 0.84 vs 0.84; NEWS2: 0.86 vs 0.84). Increasing NEWS2 values reflected increased mortality, but for any given value the absolute risk was on average 24% higher (eg, NEWS2=5: 36% vs 9%).
conclusionsThe index or on-admission NEWS and NEWS2 offers lower discrimination for COVID-19 admissions versus non-COVID-19 admissions. The index NEWS2 was not proven to be better than the index NEWS. For each value of the index NEWS/NEWS2, COVID-19 admissions had a substantially higher risk of mortality than non-COVID-19 admissions which reflects the increased baseline mortality risk of COVID-19.
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