MDCalc

4C Mortality Score for COVID-19

Predicts in-hospital mortality in patients admitted with COVID-19.

Use with admitted patients diagnosed with COVID-19.

Age, years

Sex at birth

Number of comorbidities

Comorbidities include chronic cardiac disease, chronic respiratory disease (excluding asthma), chronic renal disease (estimated glomerular filtration rate ≤30), mild to severe liver disease, dementia, chronic neurological conditions, connective tissue disease, diabetes mellitus (diet, tablet, or insulin controlled), HIV or AIDS, and malignancy.

Respiratory rate, breaths/min

Peripheral oxygen saturation on room air

Glasgow Coma Scale

Select measurement available

BUN

C-reactive protein

Result:

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Advice
  • Threshold for level of care may change during resource-limited situations such as the current COVID-19 outbreak.
  • Apply to admitted patients and not designed to influence the decision to discharge at initial presentation.

Management
  • Low risk - May be suitable for outpatient management
  • Intermediate risk - May be suitable for general inpatient treatment
  • High risk - May require aggressive treatment and higher level of monitoring
Critical Actions

When applying to a hospitalized COVID-19 patient, score may be used in conjunction with clinical suspicion to determine mortality risk and appropriate level of care.

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