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We developed a multianalyte VISUAL score (variable immunodeficiency score upfront analytical link) aimed to predict severity using individual CVID patient data at baseline of a cohort of 50 CVID patients from two different centers in Portugal and Spain. We retrospectively applied VISUAL to the CVID clinical severity scores proposed by Ameratunga and Grimbacher after 15\u00a0years follow-up of our cohort.\u00a0VISUAL score at CVID diagnosis showed adequate performance for predicting infectious and non-infectious severe complications (Cluster B). Compared to switched memory B lymphocyte phenotype alone, VISUAL provided a more accurate identification of clinically meaningful outcome, with significantly higher sensitivity (85% <jats:italic>vs<\/jats:italic> 55%, p\u2009=\u20090.01), and negative predictive value (77% <jats:italic>vs<\/jats:italic> 58%) and AUC of the ROC curves (0.72 <jats:italic>vs<\/jats:italic> 0.64), with optimal cut-off level of 10. For every increase of 1 point in the VISUAL scale, the odds of being in the higher risk category (Cluster B) increased in 1.3 (p\u2009=\u20090.005) for Ameratunga\u2019s severity score and 1.26 (p\u2009=\u20090.004) for Grimbacher\u2019s severity score. At diagnosis of CVID, VISUAL score\u2009\u2265\u200910 showed 8.94-fold higher odds of severe prognosis than below this threshold. Kaplan\u2013Meier estimates for the VISUAL\u2009\u2265\u200910 points showed significantly earlier progression to Cluster B than those with VISUAL\u2009&lt;\u200910 (<jats:italic>p<\/jats:italic>\u2009=\u20090.0002). This prognostic laboratory score might allow close monitoring and more aggressive treatment in patients with scores\u2009\u2265\u200910 on a personalized basis approach. Further studies are needed to prospectively validate VISUAL score.<\/jats:p>","DOI":"10.1038\/s41598-021-91791-2","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T10:16:45Z","timestamp":1623233805000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Variable immunodeficiency score upfront analytical link (VISUAL), a proposal for combined prognostic score at diagnosis of common variable immunodeficiency"],"prefix":"10.1038","volume":"11","author":[{"given":"Kissy","family":"Guevara-Hoyer","sequence":"first","affiliation":[]},{"given":"Adolfo","family":"Jim\u00e9nez-Huete","sequence":"additional","affiliation":[]},{"given":"Julia","family":"Vasconcelos","sequence":"additional","affiliation":[]},{"given":"Esmeralda","family":"Neves","sequence":"additional","affiliation":[]},{"given":"Silvia","family":"S\u00e1nchez-Ram\u00f3n","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"key":"91791_CR1","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1128\/CMR.00001-09","volume":"22","author":"AJ Fried","year":"2009","unstructured":"Fried, A. 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