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Article

The Model for Early COvid-19 Recognition (MECOR) Score: A Proof-of-Concept for a Simple and Low-Cost Tool to Recognize a Possible Viral Etiology in Community-Acquired Pneumonia Patients during COVID-19 Outbreak

1
Department of Clinical and Experimental Medicine, Respiratory Medicine Unit, University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy
2
Department of Medical, Surgical and Health Sciences, University of Trieste, 34151 Trieste, Italy
3
Italian Liver Foundation, Basovizza, 34149 Trieste, Italy
4
Artroreuma S.R.L., Outpatient of Rheumatology Associated with the National Health System corso S. Vito 53, Mascalucia, 95030 Catania, Italy
5
Department of Clinical and Experimental Medicine, Internal Medicine Unit, Cannizzaro Hospital, University of Catania, via Messina 829, 95100 Catania, Italy
6
Unit of Endocrinology and Diabetes, Campus Bio-Medico University, 00128 Rome, Italy
7
Unit of Metabolic Diseases, “S.M. Goretti” Hospital, 04100 Latina, Italy
8
Dept Rheumatology, ASST Pini-CTO, Piazza Cardinal Ferrari 1, 20122 Milan, Italy
9
Department of Perioperative Medicine, Intensive Care and Emergency, University Hospital, 34151 Trieste, Italy
10
Infectious and Tropical Disease Unit, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy
11
Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
12
Rheumatology Division, University and IRCCS Policlinico San Matteo Foundation, Lombardia, 27100 Pavia, Italy
13
Infectious Diseases Clinic, University and IRCCS Policlinico S. Matteo Foundation, 27100 Pavia, Italy
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Diagnostics 2020, 10(9), 619; https://doi.org/10.3390/diagnostics10090619
Received: 29 June 2020 / Revised: 16 August 2020 / Accepted: 20 August 2020 / Published: 21 August 2020
(This article belongs to the Special Issue Clinical and Radiological Features of Interstitial Lung Diseases 2.0)
This study aims to assess the peripheral blood cell count “signature” of Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) to discriminate promptly between COronaVIrus Disease 19 (COVID-19) and community-acquired pneumonia (CAP). We designed a retrospective case-control study, enrolling 525 patients (283 COVID-19 and 242 with CAP). All patients had a fever and at least one of the following signs: cough, chest pain, or dyspnea. We excluded patients treated with immunosuppressants, steroids, or affected by diseases known to modify blood cell count. COVID-19 patients showed a significant reduction in white blood cells (neutrophils, lymphocytes, monocytes, eosinophils) and platelets. We studied these parameters univariately, combined the significant ones in a multivariate model (AUROC 0.86, Nagelkerke PSEUDO-R2 0.5, Hosmer–Lemeshow p-value 0.9) and examined its discriminative performance in an internally-randomized validation cohort (AUROC 0.84). The cut-off selected according to Youden’s Index (−0.13) showed a sensitivity of 84% and a specificity of 72% in the training cohort, and a sensitivity of 88% and a specificity of 73% in the validation cohort. In addition, we determined the probability of having COVID-19 pneumonia for each Model for possible Early COvid-19 Recognition (MECOR) Score value. In conclusion, our model could provide a simple, rapid, and cheap tool for prompt COVID-19 diagnostic triage in patients with CAP. The actual effectiveness should be evaluated in further, prospective studies also involving COVID-19 patients with negative nasopharyngeal swabs. View Full-Text
Keywords: COVID-19; SARS-CoV-2; coronavirus; interstitial lung disease; diagnosis; triage; pneumonia; blood cell count; platelets; neutrophils COVID-19; SARS-CoV-2; coronavirus; interstitial lung disease; diagnosis; triage; pneumonia; blood cell count; platelets; neutrophils
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MDPI and ACS Style

Sambataro, G.; Giuffrè, M.; Sambataro, D.; Palermo, A.; Vignigni, G.; Cesareo, R.; Crimi, N.; Torrisi, S.E.; Vancheri, C.; Malatino, L.; Colaci, M.; Del Papa, N.; Pignataro, F.; Roman-Pognuz, E.; Fabbiani, M.; Montagnani, F.; Cassol, C.; Cavagna, L.; Zuccaro, V.; Zerbato, V.; Maurel, C.; Luzzati, R.; Di Bella, S. The Model for Early COvid-19 Recognition (MECOR) Score: A Proof-of-Concept for a Simple and Low-Cost Tool to Recognize a Possible Viral Etiology in Community-Acquired Pneumonia Patients during COVID-19 Outbreak. Diagnostics 2020, 10, 619. https://doi.org/10.3390/diagnostics10090619

AMA Style

Sambataro G, Giuffrè M, Sambataro D, Palermo A, Vignigni G, Cesareo R, Crimi N, Torrisi SE, Vancheri C, Malatino L, Colaci M, Del Papa N, Pignataro F, Roman-Pognuz E, Fabbiani M, Montagnani F, Cassol C, Cavagna L, Zuccaro V, Zerbato V, Maurel C, Luzzati R, Di Bella S. The Model for Early COvid-19 Recognition (MECOR) Score: A Proof-of-Concept for a Simple and Low-Cost Tool to Recognize a Possible Viral Etiology in Community-Acquired Pneumonia Patients during COVID-19 Outbreak. Diagnostics. 2020; 10(9):619. https://doi.org/10.3390/diagnostics10090619

Chicago/Turabian Style

Sambataro, Gianluca, Mauro Giuffrè, Domenico Sambataro, Andrea Palermo, Giovanna Vignigni, Roberto Cesareo, Nunzio Crimi, Sebastiano E. Torrisi, Carlo Vancheri, Lorenzo Malatino, Michele Colaci, Nicoletta Del Papa, Francesca Pignataro, Erik Roman-Pognuz, Massimiliano Fabbiani, Francesca Montagnani, Chiara Cassol, Lorenzo Cavagna, Valentina Zuccaro, Verena Zerbato, Cristina Maurel, Roberto Luzzati, and Stefano Di Bella. 2020. "The Model for Early COvid-19 Recognition (MECOR) Score: A Proof-of-Concept for a Simple and Low-Cost Tool to Recognize a Possible Viral Etiology in Community-Acquired Pneumonia Patients during COVID-19 Outbreak" Diagnostics 10, no. 9: 619. https://doi.org/10.3390/diagnostics10090619

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