Supplemental/Covid weighted risk scoring

Risk scoring algorithms used by CDCR

History

In May, 2020, California Correctional Health Care Services (CCHCS) introduced the automated COVID-19 weighted risk score to help identify patients at risk for severe complications related to COVID-19 infection. Based on early scientific literature and guidance put forth by the Center for Disease Control (CDC), CCHCS used existing healthcare condition specifications, used to inform the Automated Clinical Risk System, as the basis for the automated COVID-19 weighted risk score.

The listed conditions known or thought to increase an individual’s risk for severe complications of COVID19 were then assigned a score that was considered to reflect its relative impact to an individual’s risk for hospitalization or death related to COVID-19 infection. While most risk factors were assigned a base value of one point, some conditions were given increased weight, based on scientific literature available at that time. For example, advanced age (defined as 65 and up) is considered to be the most strongly corrolated factor with being hospitalized or dying from COVID-19, so any individual meeting that criteria would be given 4 points, or 4 times the weight of a base risk factor weight of 1. Patients meeting the “high risk” criteria for certain conditions like diabetes or cardiovascular disease, or specific conditions considered to definitively increase risk for severe complications, like Chronic Obstructive Pulmonary Disease (COPD), are given 2 points.

In July, 2020, the CDC updated its list of health conditions associated with greater risk for having severe complications of COVID-19 illness, including hemoglobin disorders such as sickle-cell disease, various neurologic conditions such as dementia, and chronic kidney disease. In order to align with these national guidelines, CCHCS updated its COVID-19 weighted risk score to incorporate newly added at-risk conditions. Further, this update to CCHCS’s weighted risk score addresses some other gaps in its first version, specifically incorporating hypertension into the model as well as changing the criteria for obesity from a Body Mass Index (BMI) of 40 or greater to a BMI of 30 or greater.