The SOFA score possesses inadequate discriminant accuracy to be used for ventilator triage of COVID-19 patients. A better option is needed that incorporates variables specifically related to mortality in patients with COVID-19 pneumonia requiring mechanical ventilation.

The coronavirus disease 2019 (COVID-19) pandemic has raised concern regarding the capacity to provide care for a surge of critically ill patients that might require excluding patients with a low probability of short-term survival from receiving mechanical ventilation.

A survey identified 26 unique COVID-19 triage policies, of which 20 used some form of the Sequential Organ Failure Assessment (SOFA) score.

However, studies performed in 2016 and 2017 have shown only moderate discriminant accuracy of the SOFA score for predicting survival in intensive care unit (ICU) patients with sepsis and an area under the receiver operating characteristic curve (AUROC) of 0.74 to 0.75.

We hypothesized that the SOFA score might be less accurate in patients requiring mechanical ventilation for COVID-19 pneumonia because such patients generally have severe single-organ dysfunction and less variation in SOFA scores.

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