Comparison between Curb-65 and A-Drop severity score and its correlation with clinical outcome in Covid-19 patients admitted in a tertiary care center

Abstract

Background: Respiratory failure is the leading cause of mortality in patients with COVID-19. CURB-65 and A-DROP are widely used in predicting the severity and outcome in Community Acquired Pneumonia (CAP). However these tools have not been assessed in patients with COVID-19 infection. A simple tool to stratify patients with COVID-19 pneumonia and for predicting the outcome at the time of hospital admission would be useful. Objective: To calculate CURB-65 and A-DROP score in COVID 19 patients and to correlate them with clinical outcome, hospital stay and CT severity score. Methods: This cross sectional study included consenting adult patients who presented with COVID 19 infection confirmed by real time RT-PCR, conducted at the hospital attached to Bangalore Medical College and Research Institute involving 100 subjects. CURB-65 and A-DROP score was calculated, CT scan of thorax was done at the time of admission. Patients underwent various biochemical investigations. Based on WHO criteria patients were divided into mild, moderate and severe COVID-19 illness. We assessed the outcome with relation to measured CURB-65 /A-DROP score to know the prognosis in COVID19 patients. Results: The meanSD age of the subjects was 55.61  14.22 with 34 females and 66 males. Among 100 patients 76(76%) recovered where as death was seen in 24(24%). Maximum recovered patients had CURB-65 score 0, 1 and 2 and A-DROP score 0, 1 and 2 whereas maximum death patients had CURB-65 score 3, 4 and 5 and A-DROP score of 3,4 and 5. Chi-square test showed statistical significant association between CURB-65 score and Outcome (2=39.7; p=0.00), statistical significant association was also between A-DROP score and Outcome (2= 43.55; p=0.00). Chi-square test applied to associate the A-DROP and CURB-65 score showed statistical significant association between the two scores (2= 194.65; p=0.00). Both the scores individually showed statistically significant correlation with CT severity and duration of hospital stay. Conclusion:This study revealed significant correlation between the clinical severity of COVID 19 illness with CURB-65 and A-DROP scores. Study also showed significant correlation between the two measured scores with CT severity score and also duration of hospital stay. Hence, CURB-65 and A-DROP score can be used to assess the severity and predict the outcome in COVID 19 infection.