{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T12:59:25Z","timestamp":1781182765126,"version":"3.54.1"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T00:00:00Z","timestamp":1736467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"German Federal Ministry of Education and Research","award":["01KX2021"],"award-info":[{"award-number":["01KX2021"]}]},{"name":"National Pandemic Cohort Network","award":["01KX2121"],"award-info":[{"award-number":["01KX2121"]}]},{"name":"Bavarian Ministry of Research and Art"},{"DOI":"10.13039\/100009139","name":"German Center for Infection Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009139","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Existing risk evaluation tools underperform in predicting intensive care unit (ICU) admission for patients with coronavirus disease 2019 (COVID-19). This study aimed to develop and evaluate an accurate and calculator-free clinical tool for predicting ICU admission at emergency room (ER) presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from patients with COVID-19 in a nationwide German cohort (March 2020\u2013January 2023) were analyzed. Candidate predictors were selected based on literature and clinical expertise. A risk score, predicting ICU admission within seven days of ER presentation, was developed using elastic net logistic regression on a northern German cohort (derivation cohort), evaluated on a southern German cohort (evaluation cohort), and externally validated on a Colombian cohort. Performance was evaluated through discrimination, calibration, and clinical utility against existing tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ICU admission rates within seven days were 30.8% (derivation cohort, n = 1295, median age 60, 38.1% female), 28.1% (evaluation cohort, n = 1123, median age 58, 36.9% female), and 30.3% (Colombian cohort, n = 780, median age 57, 38.8% female). The 11-point CROSS score, based on Confusion, Respiratory rate, Oxygen Saturation (with or without concurrent supplemental oxygen), and oxygen Supplementation, demonstrated good discrimination (area under the curve: 0.77 in the evaluation cohort; 0.69 in the Colombian cohort), good calibration, and superior clinical utility compared to existing tools. Mortality-predicting tools performed poorly in predicting ICU admission risk for patients with COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The calculator-free CROSS score effectively predicts ICU admission for patients with COVID-19 in the ER. Further studies are needed to assess its generalizability in other settings. Mortality-predicting tools are not recommended for ICU admission prediction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf006","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T07:15:27Z","timestamp":1736320527000},"page":"1022-1031","source":"Crossref","is-referenced-by-count":3,"title":["Predicting the Risk of Intensive Care Unit Admission in Patients With COVID-19 Presenting in the Emergency Room: Development and Evaluation of the Confusion, Respiratory Rate, Oxygen Saturation With or Without Concurrent Supplemental Oxygen, and Oxygen Supplementation Score"],"prefix":"10.1093","volume":"80","author":[{"given":"Weiwei","family":"Xiang","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Respiratory and Critical Care Medicine, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fridolin","family":"Steinbeis","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Respiratory and Critical Care Medicine, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4849-732X","authenticated-orcid":false,"given":"Kiret","family":"Dhindsa","sequence":"additional","affiliation":[{"name":"Berlin Institute of Health at Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3807-473X","authenticated-orcid":false,"given":"Florian","family":"Kurth","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, 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