Comparison of severity scores for COVID-19 patients with pneumonia: a retrospective study

Abstract

BackgroundUse of existing disease severity scores would greatly contribute to risk stratification and rationally resource allocation in COVID-19 pandemic. However, the performance of these scores in COVID-19 hospitalised patients with pneumonia was still unknown.MethodsIn this single center, retrospective study, all hospitalised patients with COVID-19 pneumonia from Wuhan Jin Yin-tan Hospital who had discharged or died as of February 15, 2020 were enrolled. Performance of PSI, CURB-65, A-DROP, CRB-65, SMART-COP, qSOFA and NEWS2 were validated. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were also estimated.ResultsAmong the 654 patients enrolled, 133 patients died and 521 were discharged. Areas of under curves (AUCs) of A-DROP, CURB-65, PSI, SMART-COP, NEWS2, CRB-65 and qSOFA in the prediction of in-hospital death were 0.87, 0.85, 0.85, 0.84, 0.81, 0.80 and 0.73 respectively.ConclusionADROP is a reliable tool for risk stratification of death in COVID-19 hospitalised patients on admission.

Performance of the quick COVID-19 severity index and the Brescia-COVID respiratory severity scale in hospitalized patients with COVID-19 in a community hospital setting

“…For community-acquired pneumonia (CAP), several prognostic scoring systems have been developed and studied since 1982, including the British Thoracic Society rule ( Anon, 1987 ), the modified British Thoracic Society rule ( Neill et al, 1996 ), the Pneumonia Severity Index ( Fine et al, 1997 ), and the CURB-65 score ( Lim et al, 2003 ), among others. Recently, the performance of these existing CAP severity scores has been tested in patients with COVID-19 ( Nguyen et al, 2020 , Satici et al, 2020 , Fan et al, 2020 ). Nevertheless, COVID-19 has proved to be more than just pneumonia, and its clinical spectrum varies from asymptomatic forms to systemic manifestations in terms of sepsis, septic shock, and multiple organ dysfunction syndromes, and affecting countries, races, and ages in different, and sometimes unpredictable, manners ( Cascella et al, 2020 , Wiersinga et al, 2020 ).…”

Is prognostic nutritional index a predictive marker for estimating all-cause in-hospital mortality in COVID-19 patients with cardiovascular risk factors?

“…Moreover, there is a lack of data in the literature on the comparison of PNI with other accepted prognostic scores such as CURB-65 and 4C mortality risk scores in predicting in-hospital mortality in COVID-19 patients. 12 , 13 Thus, in this study, we examined the association between PNI and in-hospital mortality in cases who were hospitalized with COVID-19 with a high cardiovascular risk factor burden.…”

Early prognostication of COVID-19 to guide hospitalisation versus outpatient monitoring using a point-of-test risk prediction score

“…This issue has previously been highlighted in the context of CRB-65 where low event rates in community studies of pneumonia made predictive inferences difficult to conclude [4]. Other scores that have been used in COVID-19 studies have either not been designed for this disease or have relied heavily on laboratory-measured data [24][25][26][27]. Our multivariate regression model was bootstrapped to reduce overfitting but not penalized prior to external validation.…”