A robust COVID‑19 mortality prediction calculator based on Lymphocyte count, Urea, C‑Reactive Protein, Age and Sex (LUCAS) with chest X‑rays

Surajit Ray, Abhirup Banerjee, Andrew J. Swift, Joseph Fanstone, Michail Mamalakis, Bart Vorselaars, Craig Wilkie, Joby Cole, Louise S Mackenzie, Simonne Weeks

Research output: Contribution to journalArticlepeer-review


There have been numerous risk tools developed to enable triaging of SARS-CoV-2 positive patients with diverse levels of complexity. Here we presented a simplifed risk-tool based on minimal parameters and chest X-ray (CXR) image data that predicts the survival of adult SARS-CoV-2 positive patients at hospital admission. We analysed the NCCID database of patient blood variables and CXR images from 19 hospitals across the UK using multivariable logistic regression. The initial dataset was non-randomly split between development and internal validation dataset with 1434 and 310 SARSCoV-2 positive patients, respectively. External validation of the fnal model was conducted on 741 Accident and Emergency (A&E) admissions with suspected SARS-CoV-2 infection from a separate NHS Trust. The LUCAS mortality score included fve strongest predictors (Lymphocyte count, Urea, C-reactive protein, Age, Sex), which are available at any point of care with rapid turnaround of results. Our simple multivariable logistic model showed high discrimination for fatal outcome with the area under the receiving operating characteristics curve (AUC-ROC) in development cohort 0.765 (95% confdence interval (CI): 0.738–0.790), in internal validation cohort 0.744 (CI: 0.673–0.808), and in external validation cohort 0.752 (CI: 0.713–0.787). The discriminatory power of LUCAS increased slightly when including the CXR image data. LUCAS can be used to obtain valid predictions of mortality in patients within 60 days of SARS-CoV-2 RT-PCR results into low, moderate, high, or very high risk of fatality.
Original languageEnglish
Article number18220
Number of pages14
JournalScientific Reports
Issue number1
Publication statusPublished - 29 Oct 2022

Bibliographical note

EPSRC Impact Acceleration account fund EP/R511705/1; University of Brighton COVID-19 Research Urgency Fund. AS is funded by the Wellcome Trust fellowship 205188/Z/16/Z; AB is a Royal Society University Research Fellow and is supported by the Royal Society (Grant No. URF\R1\221314).


  • Computational biology and bioinformatics
  • Biomarkers
  • Computational models
  • Health care
  • Medical research


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