Abstract
<jats:p>INTRODUCTION: Despite the widespread use of rapid risk stratification scales, their prognostic value for the COVID-19 (COronaVIrus Disease 2019) remains unclear. OBJECTIVE: To evaluate the prognostic performance of rapid scoring systems in predicting mortality and adverse outcomes (ICU admission, organ support, or death) in patients with COVID-19. MATERIALS AND METHODS: A literature search was conducted in PubMed, eLIBRARY.RU and ScienceGate for studies published from January 2019 to January 2025. Prospective and retrospective observational studies were included. Prognostic accuracy was assessed via meta-analysis of AUROC (Area Under the Receiver Operating Characteristic Curve). Data synthesis and quality assessment were performed using MedCalc 20.027, Microsoft Excel 2019 and the GRADE approach. RESULTS: Sixty observational studies (mostly cohort and retrospective designs) with 619,494 patients were included. Five scoring systems were analyzed for predicting in-hospital mortality: NEWS, NEWS2, REMS, qSOFA, and SIRS. REMS showed the highest prognostic value (AUC = 0.808; 95% CI: 0.776–0.839), while SIRS showed the lowest (AUC = 0.662; 95% CI: 0.596–0.728). The NEWS, NEWS2, and qSOFA scores demonstrated fair performance (AUC ranging from 0.722 to 0.782). High heterogeneity was observed across studies (I² > 96%, p < 0.1). The same five tools were evaluated for predicting severe COVID-19. NEWS and NEWS2 were the most accurate (AUC = 0.778; 95% CI: 0.707–0.849 and 0.738–0.819, respectively). REMS also showed fair performance (AUC = 0.733; 95% CI: 0.708–0.757) with minimal heterogeneity (I² = 0%, p > 0.1), whereas qSOFA and SIRS were less accurate. Heterogeneity remained high for NEWS, NEWS2, and qSOFA. CONCLUSIONS: This systematic review and meta-analysis indicate that REMS, NEWS, NEWS2, and qSOFA have acceptable prognostic value for predicting mortality and severe outcomes in COVID-19 patients. REMS was most effective for mortality prediction, while NEWS and NEWS2 were more suitable for identifying patients at risk of severe disease. These findings support the use of rapid scoring systems in clinical risk stratification.</jats:p>