{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:33:13Z","timestamp":1781641993457,"version":"3.54.5"},"reference-count":53,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T00:00:00Z","timestamp":1658102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The sequential organ failure assessment (SOFA) score has poor discriminative ability for death in severely or critically ill patients with Coronavirus disease 2019 (COVID-19) requiring intensive care unit (ICU) admission. Our aim was to create a new score powered to predict 28-day mortality. Methods: Retrospective, observational, bicentric cohort study including 425 patients with COVID-19 pneumonia, acute respiratory failure and SOFA score \u2265 2 requiring ICU admission for \u226572 h. Factors with independent predictive value for 28-day mortality were identified after stepwise Cox proportional hazards (PH) regression. Based on the regression coefficients, an equation was computed representing the COVID-SOFA score. Discriminative ability was tested using receiver operating characteristic (ROC) analysis, concordance statistics and precision-recall curves. This score was internally validated. Results: Median (Q1\u2013Q3) age for the whole sample was 64 [55\u201372], with 290 (68.2%) of patients being male. The 28-day mortality was 54.58%. After stepwise Cox PH regression, age, neutrophil-to-lymphocyte ratio (NLR) and SOFA score remained in the final model. The following equation was computed: COVID-SOFA score = 10 \u00d7 [0.037 \u00d7 Age + 0.347 \u00d7 ln(NLR) + 0.16 \u00d7 SOFA]. Harrell\u2019s C-index for the COVID-SOFA score was higher than the SOFA score alone for 28-day mortality (0.697 [95% CI; 0.662\u20130.731] versus 0.639 [95% CI: 0.605\u20130.672]). Subsequently, the prediction error rate was improved up to 16.06%. Area under the ROC (AUROC) was significantly higher for the COVID-SOFA score compared with the SOFA score for 28-day mortality: 0.796 [95% CI: 0.755\u20130.833] versus 0.699 [95% CI: 0.653\u20130.742, p &lt; 0.001]. Better predictive value was observed with repeated measurement at 48 h after ICU admission. Conclusions: The COVID-SOFA score is better than the SOFA score alone for 28-day mortality prediction. Improvement in predictive value seen with measurements at 48 h after ICU admission suggests that the COVID-SOFA score can be used in a repetitive manner. External validation is required to support these results.<\/jats:p>","DOI":"10.3390\/jcm11144160","type":"journal-article","created":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T11:32:23Z","timestamp":1658143943000},"page":"4160","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Development and Internal Validation of a New Prognostic Model Powered to Predict 28-Day All-Cause Mortality in ICU COVID-19 Patients\u2014The COVID-SOFA Score"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8138-8622","authenticated-orcid":false,"given":"Emanuel","family":"Moisa","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine, Faculty of Medicine, \u2018Carol Davila\u2019 University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Clinic of Anaesthesia and Intensive Care Medicine, Elias Emergency University Hospital, 011461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Corneci","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine, Faculty of Medicine, \u2018Carol Davila\u2019 University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Clinic of Anaesthesia and Intensive Care Medicine, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihai Ionut","family":"Negutu","sequence":"additional","affiliation":[{"name":"Clinic of Anaesthesia and Intensive Care Medicine, Elias Emergency University Hospital, 011461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina Raluca","family":"Filimon","sequence":"additional","affiliation":[{"name":"Clinic of Anaesthesia and Intensive Care Medicine, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea","family":"Serbu","sequence":"additional","affiliation":[{"name":"Clinic of Anaesthesia and Intensive Care Medicine, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2947-335X","authenticated-orcid":false,"given":"Mihai","family":"Popescu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine, Faculty of Medicine, \u2018Carol Davila\u2019 University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Clinic of Anaesthesia and Intensive Care Medicine, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvius","family":"Negoita","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine, Faculty of Medicine, \u2018Carol Davila\u2019 University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Clinic of Anaesthesia and Intensive Care Medicine, Elias Emergency University Hospital, 011461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana Marina","family":"Grintescu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine, Faculty of Medicine, \u2018Carol Davila\u2019 University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Clinic of Anaesthesia and Intensive Care Medicine, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2042","DOI":"10.1097\/CCM.0000000000005195","article-title":"Coronavirus Disease 2019 as Cause of Viral Sepsis: A Systematic Review and Meta-Analysis","volume":"49","author":"Karakike","year":"2021","journal-title":"Crit. 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