The role of ANDC early warning score in predicting prolonged hospitalization in SARS-Cov-2 infected patients

Aim: To evaluate the ability of the age, neutrophil-to-lymphocyte ratio, D-dimer, C-reactive protein (ANDC) score to predict prolonged hospitalization in SARS-CoV-2-infected patients.
Material and methods: This is a prospective and observational study conducted with patients hospitalized due to SARS-CoV-2 infection. The patients were divided into expected and prolonged hospitalization groups according to their length of hospital stay, and those who were hospitalized for seven days or longer were included in the prolonged hospitalization group. The receiver operating characteristic analysis was performed and the DeLong equality test was applied to compare the area under the curve values of the investigated parameters. Their odds ratios were also calculated.
Results: The study included a total of 397 patients. The median length of hospital stay was 8 days (25th-75th percentiles: 5-13). The univariant analysis revealed significant differences in the ANDC scores between the expected and prolonged hospitalization groups (101 (80.1-127) versus 114 (94.3-141), p<0.001, Mann-Whitney U test). The area under the curve value of the ANDC score in the prediction of prolonged hospitalization was 0.609 (75.91% sensitivity, 42.94% specificity, 62.3% positive predictive value, and 58.9% negative predictive value at a cut-off value of 93.5), and the odds ratio was 2.6.
Conclusion: Our results suggest that ANDC score is a predictor of prolonged hospitalization in SARS-CoV-2-infected patients. However, multicenter studies are needed to confirm our findings in larger samples.