Sequential Organ Failure Assessment Scores Poorly Predict Who Will Die from COVID-19

During each surge of COVID-19, we discuss the potential need for triaging critically ill patients in the setting of limited resources. Multiple proposed triage algorithms include use of the sequential organ failure assessment (SOFA) score. SOFA (score range, 0–24) was developed to predict mortality in sepsis patients, with six organ systems assessed and higher numbers reflecting worse organ function.

Investigators studied 675 patients with COVID-19 pneumonia who required mechanical ventilation and were admitted to 18 U.S. intensive care units from March through August 2020. SOFA scores were calculated using the worst values observed in the 48 hours prior to intubation. Nearly three quarters of patients died or were discharged to hospice. Med…