The authors reply.

Abstract

e108 www.ccmjournal.org January 2021 • Volume 49 • Number 1 DOI: 10.1097/CCM.0000000000004722 Copyright © 2020 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. We appreciate the comments by Stephens et al (1) on our article (2). Acute Physiology and Chronic Health Evaluation (APACHE) II score is evaluated based on the initial values of 12 routine physiologic measurements, age, and previous health status. It can be used to provide a general evaluation of the severity of many common diseases, with a value of 0–71 (3). Stephens et al’ s study reported that three coronavirus disease 2019 (COVID-19) patients had APACHE II score higher than 71, and two of them survived. We are interested in the reason that the scores of these patients exceed the upper limit of APACHE II score. In addition, we are wondering that why the predicted mortality calculated from the median APACHE II score was only 29.1% in the nonsurvivors, should not it be 50%? In our study, APACHE II score was higher in nonsurvivors than that in survivors of COVID-19 patients, which was consistent with the findings in the study by Liu et al (4). Another study has also reported that high APACHE II score was an independent risk factor of 28-day mortality in critically ill patients with COVID-19 (5). Further studies are needed to assess the role of APACHE II score in the risk stratification of patients with COVID-19.