The National Early Warning Score adapted to pregnancy in case of
suspicion of COVID-19 infection: evaluation in a retrospective study.
Abstract
Objective - Determine what is the best initial clinical score to
evaluate and propose adequate management to pregnant women with
suspicion of COVID-19 infection. Design – setting – population:
Retrospective study in one center (Lille, France) from 15 March 2020 to
15 April 2020. Were included all pregnant consulting in our emergency
center for a suspicion of COVID-19 infection. Methods – main outcome
measures: Women had a clinical, radiologic and biologic first evaluation
to adapt management at home or in hospitalization. The National Early
Warning Score (NEWS) and the NEWS-PREG, which is an adaptation including
trimester of pregnancy, were calculated in posteriori for each patient.
Sensitivity, specificity, predictive positive and negative value of
these scores to propose adequate management were calculated. Results: 63
women were included. Seventeen were hospitalized (27%) among 4 in
intensive care (6,5%). Sensitivity, specificity, predictive positive
value and predictive negative value to predict hospitalization of the
NEWS were respectively 52.9%, 100%, 100% and 85.2%. There were
respectively 82.4%, 93.5%, 82.4% and 93.4% for the NEWS-PREG. Areas
under the curve to predict hospitalization of the two scores were 0.77
for the NEWS and 0.88 for the NEWS-PREG. No woman was readmitted or had
to be transferred from conventionel hospitalization to intensive care
within 48 hours of her initial assessment and orientation. Conclusion:
The NEWS-PREG is an interesting initial clinical score which can be used
in case of suspicion of COVID-19 infection to propose adequate
management. It will be interesting to evaluate in a prospective study.