Abstract
Introduction It is crucial to have tools to predict the clinical deterioration of coronavirus
disease 2019 (COVID-19) patients. We aimed to study the efficacy of the National Early
Warning Scoring System (NEWS2) application in predicting the risk of clinical relapse
and outcomes in hospitalized COVID-19 patients at Palestinian specialized centers
for COVID-19.
Patients and Methods A quasi-experimental design was applied. A sample of 384 adult patients was divided
into two groups. For the pre-NEWS phase (control group) and the post-NEWS phase (study
group), all study participants were observed until death or hospital discharge.
Results Comparing the pre-NEWS phase with the post-NEWS phase, a significant decrease was
found in the mean length of hospital stay from 8.1 ± 5.5 to 6.4 ± 5.3 days (p = 0.002) and a reduction in the mortality rate from 19.8% during the pre-NEWS phase
to 12.5% during the post-NEWS phase (p = 0.071). The predictive value of NEWS was an excellent predictor of admission to
the intensive care unit (ICU), as indicated by an area under the receiver operating
characteristic curve of 0.91 (95% confidence interval: 0.87–0.96, p < 0.001). Also, a significant difference in the frequency of monitoring patients'
vital signs was observed between the control group (pre-NEWS phase) and the study
group (post-NEWS phase) following clinical deterioration (10.1 ± 7.8 [pre-NEWS phase]
vs. 23.4 ± 0.7 [post-NEWS phase], p < 0.001).
Conclusion Implementation of NEWS2 showed a significant improvement in hospitalized COVID-19
patient outcomes (length of stay, predicted ICU admissions, mortality rate, and frequency
of vital signs measurements), which indirectly raised the follow-up of those patients
by the medical team and attributed to a significant prediction of their deterioration.
Keywords COVID-19 - NEWS2 - clinical deterioration - patient outcomes - early warning scores
