On behalf of the Italian Society of Internal Medicine Ageno et al.[1] chose to use the database of a registry including 610 patients admitted with COVID-19 to five hospitals in Northern Italy in order to develop and validate a score that at the time of hospital admission would be able to predict a severe disease outcome, defined as the need of non-invasive ventilation, orotracheal intubation or death [1]. In the frame of their analysis meant to build the score and its accompanying validation the authors ultimately produced a score that, made of six clinical and laboratory variables, was able to identify patients at relatively low risk of a severe outcome who could be handled in the context of the low intensity of care offered by internal medicine wards [1]. During the selection and development of the best predictive score they chose to evaluate for inclusion data on demographic variables (age, sex, and time elapsed from disease onset), a few comorbidities (hypertension, diabetes, coronary artery disease, chronic obstructive pulmonary disease) but also an array of laboratory values obtained at admission, such as the white blood cells counts (WBC)(split by neutrophil and lymphocyte absolute counts), C-reactive protein (CRP), alanine amino transferase (ALT), aspartate amino transferase (AST), albumin, creatinine, D-dimer, and the neutrophil/lymphocyte ratio. Of these laboratory values CRP, AST, D-dimer, and the neutrophil/lymphocyte ratio were ultimately included in the actual score, with added clinical and demographic variables such as patient age and history of coronary artery disease [1].

In the context of our analysis of the database of another registry [2] implemented during the first wave of COVID-19 from February 2 to May 31 2020 in patients mainly admitted to two research hospitals acting as hubs in the metropolitan area of Milan (the capital city of Lombardy, the Italian region that was earlier and more severely hit by the SARS-CoV-2 pandemic) laboratory tests were carried out on admission in 1018 patients hospitalized with pneumonia and positive for SARS-CoV-2 RNA by RT PCR. After triage in the emergency room these patients were handled in the low-or intermediate care wards of pneumology, infectious disease or internal medicine. For our registry, we chose the laboratory tests with the main goal to ascertain the organs and body systems more compromised on admission in order to tailor on the basis of the corresponding results the type and intensity of medical support to organs and body systems other than the respiratory system. The latter, the principal one to be compromised by COVID-19, was supported by means of continuous positive airway pressure (CPAP), non-invasive ventilation (NIV) or high flow nasal cannula in patients admitted to pneumology wards, whereas those with relatively milder lung involvement were preferentially