Objective The aim of this study is to find out the potential risk factors including charlson comorbidity index (CCI) score associated with death in COVID‐19 patients hospitalised because of pneumonia and try to find a novel COVID‐19 mortality score for daily use. Methods All patients diagnosed as confirmed or probable COVID‐19 pneumonia whom hospitalised in our Chest Diseases Education and Research Hospital between March 11, 2020 and May 15, 2020 were enrolled. The optimal cut‐off values, sensitivity and specificity values and odds ratios to be used in mortality prediction of the novel scoring system created from these parameters were calculated by ROC analysis according to the area under the curve and Youden index. Results Over 383 patients (n: 33 deceased, n: 350 survivors) univariate and multivariate regression analysis showed that CCI and lymphocyte ratio were prognostic factors for COVID‐19‐related mortality. Using this analysis, a novel scoring model CoLACD ( Co VID‐19 L ymphocyte ratio, A ge, C CI score, D yspnoea) was established. The cut‐off value of this scoring system, which determines the mortality risk in patients, was 2.5 points with 82% sensitivity and 73% specificity (AUC = 0.802, 95% CI 0.777‐0.886, P < .001). The risk of mortality was 11.8 times higher in patients with a CoLACD mortality score higher than 2.5 points than patients with a score lower than 2.5 (OR = 11.8 95% CI 4.7‐29.3 P < .001). Conclusion This study showed that by using the CoLACD mortality score, clinicians may achieve a prediction of mortality in COVID‐19 patients hospitalised for pneumonia.

Although the sensitivity and specificity of nucleic acid amplification assays are high with smear-positive samples, the sensitivity with smear-negative and extrapulmonary samples for the diagnosis of tuberculosis in suspicious tuberculosis cases still remains to be investigated. This study evaluates the performance of the GenoType Mycobacteria Direct (GTMD) test for rapid molecular detection and identification of the Mycobacterium tuberculosis complex and four clinically important nontuberculous mycobacteria (M. avium, M. intracellulare, M. kansasii, and M. malmoense) in smear-negative samples. A total of 1,570 samples (1,103 bronchial aspiration, 127 sputum, and 340 extrapulmonary samples) were analyzed. When we evaluated the performance criteria in combination with a positive culture result and/or the clinical outcome of the patients, the overall sensitivity, specificity, and positive and negative predictive values were found to be 62.4, 99.5, 95.9, and 93.9%, respectively, whereas they were 63.2, 99.4, 95.7, and 92.8%, respectively, for pulmonary samples and 52.9, 100, 100, and 97.6%, respectively, for extrapulmonary samples. Among the culture-positive samples which had Mycobacterium species detectable by the GTMD test, three samples were identified to be M. intracellulare and one sample was identified to be M. avium. However, five M. intracellulare samples and an M. kansasii sample could not be identified by the molecular test and were found to be negative. The GTMD test has been a reliable, practical, and easy tool for rapid diagnosis of smear-negative pulmonary and extrapulmonary tuberculosis so that effective precautions may be taken and appropriate treatment may be initiated. However, the low sensitivity level should be considered in the differentiation of suspected tuberculosis and some other clinical condition until the culture result is found to be negative and a true picture of the clinical outcome is obtained.Acid-fast smear examination and culture (liquid-and solidbased media, automated and semiautomated systems) are conventional techniques for microbiological detection of mycobacteria causing tuberculosis (TB) (14, 24). However, the sensitivity of smear has been variable (range, 20 to 80%) (1). In some smear-negative cases, TB might be difficult to differentiate from a number of other clinical pictures. Therefore, invasive medical procedures are necessary for sampling of patients from whom a qualified sputum sample cannot be obtained or in case of extrapulmonary TB, which requires histopathological, cytopathological, and microbiological examination of tissue specimens and body fluids. Nucleic acid amplification (NAA) techniques have been used for early detection of causative mycobacteria in clinical samples and also to support the clinical and radiological diagnosis in patients with presumptive Mycobacterium tuberculosis infection (3,19,33). Although the specificity values obtained with both smear-positive and smear-negative samples are high, the sensitivities of molecular assays are rather less w...

This a preprint and has not been peer reviewed. Data may be preliminary.