We would like to share ideas on the publication “Derivation of a Clinical Risk Score to Predict 14-Day Occurrence of Hypoxia, ICU Admission, and Death Among Patients with Coronavirus Disease 2019.”1 Levine et al. “A 3-item risk score for patients with COVID-19 consisting of age, oxygen saturation, and an acute phase reactant (albumin) using point of care data predicts suitability for discharge and may optimize scarce resources.”1 Regarding albumin, the background nutritional status should be considered. In many developing countries, malnutrition is common and whether it has any confounding effect on new score system is an interesting issue for further study. Second, the quality control of point of care testing is an important issue.2 There are many possible interferences. For example, hemolysis can interfere albumin determination.3 In COVID-19, hemolysis is a possible problem and this might lead to incorrect result of albumin measurement.4
Levine DM, Lipsitz SR, Co Z, Song W, Dykes PC, Samal L. Derivation of a Clinical Risk Score to Predict 14-Day Occurrence of Hypoxia, ICU Admission, and Death Among Patients with Coronavirus Disease 2019. J Gen Intern Med. 2020. doi: https://doi.org/10.1007/s11606-020-06353-5. Online ahead of print.
Hicks JM, Haeckel R, Price CP, Lewandrowski K, Wu AH. Recommendations and opinions for the use of point-of-care testing for hospitals and primary care: summary of a 1999 symposium. Clin Chim Acta. 2001;303(1-2):1-17.
Lippi G, Salvagno GL, Montagnana M, Brocco G, Guidi GC. Influence of hemolysis on routine clinical chemistry testing. Clin Chem Lab Med. 2006;44(3):311-6.
Sahu KK, Borogovac A, Cerny J. COVID-19 related immune hemolysis and thrombocytopenia. J Med Virol. 2020:10.1002/jmv.26402. doi: https://doi.org/10.1002/jmv.26402. Online ahead of print.
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Mungmunpuntipantip, R., Wiwanitkit, V. Clinical Risk Score and COVID-19. J GEN INTERN MED (2021). https://doi.org/10.1007/s11606-021-06721-9