Prognostic Performance of the CALL Score in Hospitalized Patients with COVID-19 Pneumonia

Abstract

Objective: Scoring systems are frequently used to predict disease severity and mortality in many different clinical conditions. The prognostic significance of a new scoring system developed for patients who are hospitalized due to Coronavirus disease-2019 (COVID-19) pneumonia, which is named CALL that stands for comorbidity (C), age (A), lymphocyte count (L), and lactate dehydrogenase (LDH) (L), was evaluated. Methods: This is a retrospective and observational study on 582 patients who were hospitalized due to moderate or severe COVID-19 pneumonia after being diagnosed as positive using the real-time polymerase chain reaction testing. CALL scores were evaluated in the two groups of patients, namely the survivors and the non-survivors. Results: Among all patients, 339 (58.24%) were males and 272 (46.73%) were older than 60 years. Comorbidities were not found in 174 (29.89 %) patients, whereas 408 (70.11%) had one or more comorbidities, mainly hypertension (n=275, 47.25%), diabetes mellitus (n=192, 32.98%), and coronary artery disease (n=78, 13.4%). Class A consist of 113 (19.41%) patients (4-6 s), 219 (37.62%) in Class B (7-9 s), and 250 (42.95%) in Class C (10-13 s). In-hospital mortality was found to be 6% (35 cases). Only 1 (0.88%) patient in Class A and 27 (10.8%) in Class C were deceased. As a result, in-hospital mortality was observed as 27 patients in Class C and 1 in Class A. The receiver operating characteristic analysis was used to assess the performance of the CALL score; the area under the curve was 0.76 (95% confidence interval of 0.68-0.85). Using a cutoff value of 10 points, the sensitivity was 77% and specificity was 60% for predicting in-hospital mortality. Conclusion: CALL score was observed to be strongly related to in-hospital mortality. As a simple diagnostic measure, it may be used as a complementary score for the treatment planning and management of COVID-19 pneumonia in pandemic conditions.