The outbreak of the novel corona virus disease 2019 (COVID-19) began inWuhan, China in December 2019. Since then, it has rapidly spread around theworld. As of April 16, 2020, theWHOreported a total of 1 995 983COVID-19 cases globally, with average mortality of 6.57%.

Theclinical spectrumofCOVID-19pneumoniaranges from mild to critically ill cases. Patients with mild disease present with symptoms of fever and cough, followed by sputum production and fatigue. Sepsis, respiratory failure, acute respiratory distress syndrome, heart failure, and septic shock are commonly observed in critically ill patients.

According to the largest current report from the Chinese Center for Disease Control and Prevention with 72 314 cases, 58 574 patients (81%)were classified as mild, 10 124 (14%)were classified as severe, and 3616 (5%) were considered critical illness. The average case-fatality rate was 2.3%, but mortality was as high as 49% in patients with critical illness.2 Among 201 patients in Wuhan, Wu et al3 reported that risk factors associatedwithdevelopment of acute respiratory distress syndrome and death included older age, neutrophilia, organ dysfunction, coagulopathy, and elevated D-dimer levels.

Early detection of patients who are likely to develop critical illness is of great importance and may aid in delivering proper care and optimizing use of limited resources.We aimed to construct a risk prediction score based on a nationwide cohort of Chinese patients with COVID-19 to help identify patients at the time of hospital admission who are likely to develop critical illness.


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