Letter to the Editor: Variability but not admission or trends in NEWS2 score predicts clinical outcome in elderly hospitalised patients with COVID-19.

In a recent article in the Journal, Bruno and colleagues present short-term outcomes in elderly patients with severe COVID-19 disease admitted to a single Italian Infectious Disease unit.1 The study found that elderly patients are at increased risk of adverse outcomes due to high number of comorbidities and emphasises the need to improve clinical management in these patients. In particular, elderly patients who are likely to deteriorate will need to be rapidly identified.2 Existing prognostic models for COVID-19 based on clinical, laboratory and radiological variables are at high risk of bias.3 In the UK, the National Early Warning Score (NEWS) and its updated version NEWS2 – an a priori weighted composition of the patient's observations - is used routinely to monitor patients in hospital and identify early those who may deteriorate.4 [Opening paragraph]