Uncertainty surrounding COVID-19 regarding rapid progression to acute respiratory distress syndrome (ARDS) and unusual clinical characteristics make discharge from a monitored setting challenging.

Model derivation and validation in a retrospective cohort. We built a manual forward stepwise logistic regression model to identify variables associated with suitability for discharge and assigned points to each variable.

All adult patients with a COVID-19 diagnosis between March 1, 2020, and April 12, 2020, in 10 hospitals in Massachusetts, USA.

A 3-item risk score for patients with COVID-19 consisting of age, oxygen saturation, and an acute phase reactant (albumin) using point of care data predicts suitability for discharge and may optimize scarce resources.

Of 2,059 patients with COVID-19, 1,326 met inclusion. The 1,014-patient training cohort had a mean age of 58 years, was 56% female, and 65% had at least one comorbidity. A total of 255 (25%) patients were suitable for discharge.

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