Nonadverse COVID-19 evolution predictors: the CoNAE scale

Esther Pulido-Herrero1,2,4,6,7, Nere Larrea3,5-7, Susana García-Gutiérrez3-7, María S. Gallardo1,2,4, Julio J. Gamazo-Del-Río1,2, María Gascón3,5-7, María-José Legarreta3,5-7, Ane Villanueva3,5-7, José M. Quintana3,5-7 y el Grupo de Investigación COVID-Health Basque Country

Filiación de los autores

1Servicio Vasco de Salud de Osakidetza, Unidad de Urgencias, Hospital Universitario Galdakao- Usansolo, Barakaldo, Spain. 2Grupo de Urgencias, Instituto de Investigación Sanitaria Biocruces Bizkaia, Barakaldo, Spain. 3Servicio Vasco de Salud de Osakidetza, Unidad de Investigación, Hospital Universitario Galdakao-Usansolo, Barakaldo, Spain. 4Departamento de Medicina, Facultad de Ciencias de la Salud, Universidad de Deusto, Spain. 5Kronikgune Institute for Health Services Research, Barakaldo, Spain. 6Red de Investigación de Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Bizkaia, Spain. 7Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS).



Pulido-Herrero E, Larrea N, García-Gutiérrez S, Gallardo MS, Gamazo-Del-Río JJ, Gascón M, et al. Nonadverse COVID-19 evolution predictors: the CoNAE scale. Emergencias. 2023;35:335-44


Background and objectives. Tools to identify patients with mild to moderate COVID-19 are as yet unavailable. Our aims were to identify factors associated with nonadverse outcomes and develop a scale to predict nonadverse evolution in patients with COVID-19 (the CoNAE scale) in hospital emergency departments.


Retrospective cohort study of patients who came to one of our area’s national health service hospitals for treatment of SARS-CoV-2 infection from July 1, 2020, to July 31, 2021. From case records we collected sociodemographic information, underlying comorbidity and ongoing treatments, other relevant medical history details, and vital constants on arrival for triage. Multilevel multivariable logistic regression models were used to identify predictors.


The model showed that patients who had nonadverse outcomes were younger, female, and vaccinated against COVID-19 (2 doses at the time of the study). They arrived with normal vital signs (heart rate, diastolic and systolic pressures, temperature, and oxygen saturation) and had none of the following concomitant diseases or factors: heart failure other heart disease, hypertension, diabetes, liver disease, dementia, history of malignant tumors, and they were not being treated with oral or other systemic corticosteroids or immunosuppressant therapy. The area under the receiver operating characteristic curve for the model was 0.840 (95% CI, 0.834-0.847).


We developed the CoNAE scale to predict nonadverse outcomes. This scale may be useful in triage for evaluating patients with COVID-19. It may also help predict safe discharge or plan the level of care that patients require not only in a hospital emergency department but also in urgent primary care settings or out-of-hospital emergency care.


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