Validation of the 4C Deterioration Model for COVID-19 in a UK teaching hospital during Wave 2

The 4C Deterioration model was developed and validated on data collected in UK hospitals until August 26, 2020, but has not yet been validated in the presence of SARS-CoV-2 variants and novel treatment regimens that have emerged subsequently. In this first validation study of the 4C Deterioration model on patients admitted between August 27, 2020 and April 16, 2021 we found, despite a slightly overestimation of risk, that the discrimination (area under the curve 0.75, 95% CI 0.71-0.78) and calibration of the model remained consistent with the development study, strengthening the evidence for adopting this model into clinical practice.