covid_gram_score: COVID-GRAM Critical Illness Risk Score

In cliot: Clinical Indices and Outcomes Tools

COVID-GRAM Critical Illness Risk Score

Description

Calculates the COVID-GRAM score to predict the risk of developing critical illness in patients hospitalized with COVID-19. Critical illness is defined as admission to the intensive care unit, invasive mechanical ventilation, or death. The model was developed by Liang et al. using data from 575 hospitals in China.

Usage

covid_gram_score(age, x_ray_abnormality, hemoptysis, dyspnea, unconsciousness,
                 number_of_comorbidities, cancer_history, nlr, ldh,
                 direct_bilirubin, bilirubin_units = "umol/L")

Arguments

age	Numeric. Patient age in years.
x_ray_abnormality	Numeric (0 or 1). Presence of radiographic abnormalities on Chest X-ray/CT. (1 = Yes).
hemoptysis	Numeric (0 or 1). Presence of hemoptysis. (1 = Yes).
dyspnea	Numeric (0 or 1). Presence of dyspnea. (1 = Yes).
unconsciousness	Numeric (0 or 1). Presence of unconsciousness or altered mental status. (1 = Yes).
number_of_comorbidities	Numeric. Count of comorbidities (e.g., COPD, hypertension, diabetes, coronary heart disease, CKD, etc.). (0, 1, or >=2).
cancer_history	Numeric (0 or 1). History of cancer. (1 = Yes).
nlr	Numeric. Neutrophil-to-lymphocyte ratio.
ldh	Numeric. Lactate dehydrogenase level (U/L).
direct_bilirubin	Numeric. Direct bilirubin level.
bilirubin_units	String. Units for direct bilirubin. "umol/L" (default) or "mg/dL".

Value

A list containing:

Critical_Illness_Probability	The estimated percentage probability of critical illness.
Risk_Category	Risk stratification (Low < 1.7%, Medium 1.7-40.4%, High > 40.4%).

References

Liang W, Liang H, Ou L, et al. Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19. JAMA Intern Med. 2020;180(8):1081-1089. doi:10.1001/jamainternmed.2020.2033

Examples

# Example 1: High Risk
# 70yo, Abnormal CXR, Dyspnea, 2 Comorbs, Cancer, NLR 10, LDH 400, D-Bili 6 umol/L
covid_gram_score(70, 1, 0, 1, 0, 2, 1, 10, 400, 6, "umol/L")

# Example 2: Low Risk
# 30yo, Normal CXR, No symptoms, 0 Comorbs, Normal Labs
covid_gram_score(30, 0, 0, 0, 0, 0, 0, 2, 150, 3, "umol/L")

cliot documentation built on Dec. 1, 2025, 1:06 a.m.