Calculator

ABC$_2$-SPH Mortality Score for COVID-19

Estimates in-hospital mortality in patients admitted for COVID-19.

Information

When to use?

At admission in the emergency department, to stratify the in-hospital mortality risk of patients with COVID-19.

How was it developed and validated?

Based in a cohort of 5,032 patients from 36 hospitals, from 17 cities in Brazil, as well as a cohort of 474 Spanish patients, following strict methodological criteria. $^{1,2}$

Why to use?

  • It is easily calculated at bedside at admission.
  • It identifies four categories at increasing risk of death with a high level of accuracy, which outperformed other existing scores.
  • It may help healthcare practitioners to better identify patients with higher risk of mortality, to inform early interventions and the need of repetitive assessments to reduce the risk of death.

How it should be used?

Only inhospital patients, through the use of variables easily accessible at admission.

How it should not be used?

  • It should not be considered a medical device.
  • It must not be interpreted as patients from low risk group may be discharged for home treatment.
  • It was validated in a cohort of Brazilian patients, and it should not be adopted for routine clinical use in other settings until it has been appropriately externally validated in those settings.

Calculator

VariableABC$_2$-SPH Score
$A$$A$ge ($years$)
$\lt$ 600
60 - 691
70 - 793
$\geqslant$ 805
$B$$B$lood urea nitrogen ($mg/dL$)*
$\lt$ 420
$\geqslant$ 423
Or urea ($mg/dL$)*
$\lt$ 900
$\geqslant$ 903
$C_2$$C$omorbidities (hypertension, diabetes mellitus, obesity, coronary artery disease, heart failure, atrial fibrillation or flutter, cirrhosis, cancer, COPD and previous stroke)
0 - 10
$\geqslant$ 21
$C$ reactive protein ($mg/L$)
$\lt$ 1000
$\geqslant$ 1001
$S$$S$pO$_2$/FiO$_2$ (%)
$\gt$ 3150
235.1 - 315.01
150.1 - 2353
$\leqslant$ 1506
$P$$P$latelet count ($x10^9/L$)
$\gt$ 1500
100 - 1501
$\lt$ 1002
$H$$H$earth rate ($bpm$)
$\leqslant$ 900
91 - 301
$\geqslant$ 1312

Publications

Publication: Marcolino MS, Pires MC, Ramos LEF, Silva RT, Oliveira LM, et al. ABC2-SPH risk score for in-hospital mortality in COVID-19 patients: development, external validation and comparison with other available scores. Int J Infect Dis. 2021;110:281-308. doi: 10.1016/j.ijid.2021.07.049. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1201-9712(21)00605-6

Team

Milena Soriano Marcolino$^1$, Magda Carvalho Pires$^2$, Rafael Tavares Silva$^3$, Lucas Emanuel Ferreira Ramos$^3$, Luana Martins Oliveira$^4$, Daniel Taiar Marinho Oliveira Ferrara$^5$, Maira Viana Rego Souza e Silva$^6$, Rafael Lima Rodrigues de Carvalho$^6$, Luanna da Silva Monteiro$^7$,Thaís Lorenna Souza Sales$^8$, Karina Paula Medeiros Prado Martins$^6$, Israel Júnior Borges do Nascimento$^6$, Talita Fischer Oliveira$^9$, Carisi Anne Polanczyk$^{10}$, Adrián Sánchez-Montalvá$^{11}$, Adriana Falangola Benjamin Bezerra$^{12}$, Alexandre Vargas Schwarbold$^{13}$, Aline Gabrielle Souza Nunes$^{14}$, Amanda de Oliveira Maurílio$^{15}$, Ana Lara Rodrigues Monteiro de Barros$^{16}$, Ana Luiza Bahia Alves Scotton$^{17}$, Ana Paula Beck da Silva Etges$^{10}$, Ana Paula Coutinho$^{18}$, Anderson Lacerda dos Reis$^{19}$, André Pinheiro Weber$^{20}$, André Soares de Moura Costa$^{21}$, Andresa Fontoura Garbini$^{22}$, Andressa Barreto Glaeser$^{23}$, Anelise Ferreira Fontana$^{22}$, Angélica Aparecida Coelho Madureira$^{16}$, Angelinda Rezende Bhering$^{14}$, Argenil José Assis de Oliveira$^{24}$, Bárbara Lopes Farace$^{24}$, Berta Raventós$^{25}$, Bruna Thais Schaefer$^{23}$, Bruno Mateus de Castro$^{18}$, Camila Felix Fortis$^{18}$, Carla Thais Cândida Alves da Silva$^{26}$, Carolina Marques Ramos$^{27}$, Caroline Danubia Gomes$^{19}$, Cássia Regina Gotler Medeiros$^{20}$, Christiane Corrêa Rodrigues Cimini$^{28}$, Cíntia Alcantara de Carvalho$^{29}$, Claudete Rempel$^{20}$, Claudiamara Borsatto$^{30}$, Daniel Vitório Silveira$^{14}$, Daniela Antunes de Lima$^{31}$, Daniela Ponce$^{32}$, Diego Henrique de Vasconcelos$^{33}$, Edilson Cezar$^{34}$, Elayne Crestani Pereira$^{35}$, Eliane Würdig Roesch$^{18}$, Emanuel Victor Alves Costa$^{36}$, Emanuele Marianne Souza Kroger$^{27}$, Euler Roberto Fernandes Manenti$^{19}$, Felipe Barbosa Vallt$^{26}$, Fernanda Barbosa Lucas$^{26}$, Fernanda d’Athayde Rodrigues$^{18}$, Fernanda Doumith Madureira$^{37}$, Fernando Anschau$^{22}$, Fernando Antonio Botoni$^{27}$, Fernando Graça Aranha$^{35}$, Filipe Carrilho de Aguiar$^{12}$, Francine Bernardo Vieira Pedroso$^{34}$, Frederico Bartolazzi$^{26}$, Gabriela Petry Crestani$^{19}$, Giovanna Grunewald Vietta$^{35}$, Gisele Alsina Nader Bastos$^{23}$, Glícia Cristina de Castro Madeira$^{16}$, Guilherme Fagundes Nascimento$^{14}$, Helena Carolina Noal$^{13}$, Helena Duani$^{33}$, Hellen Katya Wiebbelling$^{30}$, Heloisa Reniers Vianna$^{38}$, Henrique Cerqueira Guimarães$^{24}$, Isabela Moraes Gomes$^{16}$, Israel Molina$^{39}$, Izabel Cristina Sad das Chagas$^{37}$, Jamille Hemétrio Salles Martins Costa$^{31}$, Jéssica Rayane Corrêa Silva da Fonseca$^{40}$, Jessica Restello$^{30}$, Joanna d’Arc Lyra Batista$^{30}$, Joice Coutinho de Alvarenga$^{29}$, José Miguel Chatkin$^{41}$, Júlia Di Sabatino Santos Guimarães$^{27}$, Júlia Drumond Parreiras de Morais$^{38}$, Juliana da Silva Nogueira$^{12}$, Juliana Machado Rugolo$^{32}$, Juliana Tereza Coneglian de Almeida$^{32}$, Kaique Amancio Alvim Gouvea$^{40}$, Karen Brazil Ruschel$^{34}$, Karen Cristina Jung Rech Pontes$^{30}$, Kauane Aline Maciel dos Santos$^{18}$, Lara de Barros Wanderley Gomes$^{40}$, Lara Monalyza Gonçalves Franco$^{42}$, Leila Beltrami Moreira$^{18}$, Leonardo Hansen$^{30}$, Leonardo Seixas de Oliveira$^28$, Lílian Santos Pinheiro$^28$, Liliane Souto Pacheco$^{13}$, Luana Fonseca de Almeida$^{24}$, Lucas de Deus Sousa$^{17}$, Luciana Siuves Ferreira Couto$^{21}$, Luciane Kopittke$^{22}$, Luciano de Souza Viana$^{31}$, Luís César de Castro$^{20}$, Luis Cesar Souto de Moura$^{43}$, Luís Eduardo Stefani Brusamarello$^{41}$, Luis Joeci Jacques de Macedo Junior$^{22}$, Luisa Argolo Assis$^{27}$, Luisa Elem Almeida Santos$^{17}$, Luiz Antonio Nasi$^{23}$, Máderson Alvares de Souza Cabral$^{33}$, Magda Cesar Raposo$^{24}$, Maiara Anschau Floriani$^{23}$, Maíra Dias Souza$^{9}$, Majlla Magalhães Silva$^{31}$, Marcela Gonçalves Trindade Tofani$^{40}$, Marcelo Carneiro$^{44}$, Marconi Franco da Silveira$^{31}$, Marcus Vinicius Melo de Andrade$^{33}$, Maria Angélica Pires Ferreira$^{18}$, Maria Aparecida Camargos Bicalho$^{45}$, Maria Auxiliadora Parreiras Martins$^{21}$, Maria Clara Pontello Barbosa Lima$^{21}$, Mariana Balbinot Borges$^{34}$ Mariana de Braga Lima Carvalho Canesso$^{45}$, Mariana Frizzo de Godoy$^{41}$, Marilia Mastrocolla de Almeida Cardoso$^{32}$, Matheus Carvalho Alves Nogueira$^{21}$, Matheus Fernandes Lopes Martins$^{31}$, Meire Pereira de Figueiredo$^{26}$, Milton Henriques Guimarães Júnior$^{31}$, Mônica Aparecida de Paula de Sordi$^{32}$, Mychelle Stefany Santos Almeida$^{8}$, Natália da Cunha Severino Sampaio$^{36}$, Natália Lima Rangel$^{31}$, Natália Trifiletti Crespo$^{31}$, Neimy Ramos de Oliveira$^{36}$, Nicole de Moraes Pertile$^{23}$, Patricia Klarmann Ziegelmann$^{46}$, Pedro Guido Soares Andrade$^{40}$, Pedro Ledic Assaf$^{16}$, Petrônio José de Lima Martelli$^{12}$, Rafael Armando Seewald$^{20}$, Rafaela dos Santos Charão de Almeida$^{22}$, Rangner José Almeida Valença Mota$^{12}$, Raphael Castro Martins$^{43}$, Raquel Lutkmeier$^{22}$, Raulério Goulart Papini$^{30}$, Reginaldo Aparecido Valacio$^9$, Renan Goulart Finger$^{30}$, Ricardo Bertoglio Cardoso$^{10}$, Ricardo Braga Coelho$^{14}$, Roberta Pozza$^{43}$, Roberta Xavier Campos$^{27}$, Rochele Mosmann Menezes$^{44}$, Rodolfo Lucas Silva Mourato$^{15}$, Rodrigo Costa Pereira Vieira$^{42}$, Roger Mendes de Abreu$^{16}$, Rufino de Freitas Silva$^{15}$, Saionara Cristina Francisco$^{16}$, Silvana Mangeon Mereilles Guimarães$^{40}$, Silvia Ferreira Araújo$^{40}$, Sofia Jarjour Tavares Starling Lopes$^{27}$, Susany Anastácia Pereira$^{16}$, Taíse Maria Clemente de Araújo$^{12}$, Talita Regina Fiorio$^{43}$, Tatiana de Vargas$^{34}$, Tatiana Kurtz$^{44}$, Tatiani Oliveira Fereguetti$^{36}$, Thainara Conceição de Oliveira$^{34}$, Thaíza Simônia Marinho Albino de Araújo$^{16}$, Thalita Martins Lage$^{31}$, Thulio Henrique Oliveira Diniz$^{15}$, Umbelina Cravo Teixeira Lagioia$^{12}$, Veridiana Baldon dos Santos$^{22}$, Victor Eliel Bastos de Carvalho$^{27}$, Vinícius Andrade Almeida$^{12}$, Virginia Mara Reis Gomes$^{36}$, Vitor Augusto Lima do Vale$^{24}$, William Rutzen$^{44}$, Yuri Carlotto Ramires$^{20}$, Zilma Silveira Nogueira Reis$^{8}$


$^1$Principal investigator. Medical School, Telehealth Center and University Hospital, Universidade Federal de Minas Gerais; Instituto de Avaliação de Tecnologia em Saúde (IATS), Belo Horizonte, Brazil
$^2$Statistical coordinator. Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
$^3$Statistical team. Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
$^4$Field coordinator. Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
$^5$UX designer. Universidade FUMEC, Belo Horizonte, Brazil
$^6$Medical School, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
$^7$Hospital Metropolitano Odilon Behrens, Hospital Luxemburgo, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
$^8$Universidade Federal de São João del-Rei, São João del-Rei, Brazil
$^9$Hospital Metropolitano Odilon Behrens, Belo Horizonte, Brazil
$^{10}$Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
$^{11}$Vall d’Hebron University Hospital, Vall d’Hebron Institute of Research (VHIR), Barcelona, Spain $^{12}$University Hospital, Universidade Federal de Pernambuco, Recife, Brazil
$^{13}$Hospital Universitário de Santa Maria, Santa Maria, Brazil
$^{14}$Hospital UNIMED, Belo Horizonte, Brazil
$^{15}$Hospital São João de Deus, Divinópolis, Brazil
$^{16}$Hospital Metropolitano Doutor Célio de Castro, Belo Horizonte, Brazil
$^{17}$Hospital Regional Antônio Dias, Patos de Minas, Brazil
$^{18}$Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
$^{19}$Hospital Mãe de Deus, Porto Alegre, Brazil
$^{20}$Hospital Bruno Born, Lajeado, Brazil
$^{21}$Hospitais da Rede Mater Dei, Belo Horizonte, Brazil
$^{22}$Hospital Nossa Senhora da Conceição, Hospital Cristo Redentor, Porto Alegre, Brazil
$^{23}$Hospital Moinhos de Vento, Porto Alegre, Brazil
$^{24}$Hospital Risoleta Tolentino Neves, Belo Horizonte, Brazil
$^{25}$Infectious Diseases Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
$^{26}$Hospital de Santo Antônio, Curvelo, Brazil
$^{27}$Hospital Julia Kubitschek, Belo Horizonte, Brazil
$^{28}$Hospital Santa Rosália, Teófilo Otoni, Brazil
$^{29}$Hospital João XXIII, Belo Horizonte, Brazil
$^{30}$Hospital Regional do Oeste, Chapecó, Brazil
$^{31}$Hospital Márcio Cunha, Ipatinga, Brazil
$^{32}$University Hospital, Faculdade de Medicina de Botucatu, Botucatu, Brazil
$^{33}$University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil $^{34}$Hospital Universitário Canoas, Canoas, Brazil
$^{35}$Hospital SOS Cárdio, Florianópolis, Brazil
$^{36}$Hospital Eduardo de Menezes, Belo Horizonte, Brazil
$^{37}$Hospital Regional de Barbacena Dr. José Américo, Barbacena, Brazil
$^{38}$Hospital Universitário Ciências Médicas, Belo Horizonte, Brazil
$^{39}$Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
$^{40}$Hospital Semper, Belo Horizonte, Brazil
$^{41}$Hospital São Lucas da PUCRS, Porto Alegre, Brazil
$^{42}$Hospital Luxemburgo, Instituto Mario Pena, Belo Horizonte, Brazil
$^{43}$Hospital Tacchini, Bento Gonçalves, Brazil
$^{44}$Hospital Santa Cruz, Santa Cruz do Sul, Brazil
$^{45}$Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, Brazil
$^{46}$Hospital Tacchini, Instituto de Avaliação de Tecnologia em Saúde (IATS), Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

Contact

  • milenamarc@ufmg.br
  • +55 3133079201
  • 110, Professor Alfredo Balena Avenue, Belo Horizonte, Minas Gerais, Brazil, 30130-100
  • Telehealth Center, University Hospital, Universidade Federal de Minas Gerais
  • Monday to Friday 7:00 to 19:00
    UTC/GMT -03:00