Severity scores in COVID-19 pneumonia: a multicenter, retrospective, cohort study

Artero, Arturo; Madrazo, Manuel; Fernández-Garcés, Mar; Miguez, Antonio Muñoz; García, Andrés González; Vieitez, Anxela Crestelo; Guijarro, Elena García; Aizpuru, E. M. Fonseca; Gómez, Miriam García; Manrique, María Areses; Cilleros, Carmen Martínez; Moreno, María del Pilar Fidalgo; Loureiro-Amigo, José; Sánchez, Ricardo Gil; Pejenaute, Elisa Rabadán; Vázquez, Lucy Abella; Navarro, Ruth Cañizares; Marquínez, Marta Nataya Solís; Sánchez, Francisco Javier Carrasco; Moraleja, Julio González; Rivas, Lorena Montero; Sevilla, J. Escobar; Escalante, María Dolores Martín; Gómez‐Huelgas, Ricardo; Ramos-Rincón, José-Manuel

doi:10.21203/rs.3.rs-83788/v1

Cited by 6 publications

(8 citation statements)

References 26 publications

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“…Moreover, PSI and CURB-65 both performed well in the evaluation of patients' disease severity (Kappa = 0.69, P < 0.001). Our results are in consistency with those reported by Artero et al 9 and Satici et al 13 Thus our findings suggest that PSI and CURB-65 might be useful to predict the severity and mortality of COVID-19 pneumonia. A previous study showed that patients with COVID-19 pneumonia who had compromised respiratory status on admission were at a higher risk of developing severe disease and worse outcomes.…”

Section: Discussionsupporting

confidence: 93%

“…qSOFA score is simple, and qSOFA score ≥ 2 predicted the severity of COVID-19, with a sensitivity of 26.7%. 9 The study by Myrstad et al 10 showed that National Early Warning Score 2 (NEWS2) score was superior to qSOFA, Systemic Inflammatory Response Syndrome (SIRS) criteria and CRB-65 in predicting COVID-19 pneumonia severe and mortality. The finding from Ji et al 11 suggested that the CALL (comorbidity, age, lymphocyte, and Lactate Dehydrogenase; LDH) score could predict the progression risk in patients with COVID-19 pneumonia.…”

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confidence: 99%

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Performance of CURB-65, PSI, and APACHE-II for predicting COVID-19 pneumonia severity and mortality

Chen

Liu

et al. 2021

Eur J Inflamm

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No prognostic tools for the prediction of COVID-19 pneumonia severity and mortality are available. We explored whether CURB-65, PSI, and APACHE-II could predict COVID-19 pneumonia severity and mortality. We included 167 patients with confirmed COVID-19 pneumonia in this retrospective study. The severity and 30-day mortality of COVID-19 pneumonia were predicted using PSI, CURB-65, and APACHE-II scales. Kappa test was performed to compare the consistency of the three scales. There was a significant difference in the distribution of the scores of the three scales ( P < 0.001). Patients with PSI class ⩽III, CURB-65 ⩽1, and APACHE-II-I all survived. The ROC analysis showed the areas under the curve of the PSI, CURB-65, and APACHE-II scales were 0.83 (95% CI, 0.74–0.93), 0.80 (95% CI, 0.69–0.90), and 0.83 (95% CI, 0.75–0.92), respectively. Our findings suggest that PSI and CURB-65 might be useful to predict the severity and mortality of COVID-19 pneumonia.

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

Performance of CURB-65, PSI, and APACHE-II for predicting COVID-19 pneumonia severity and mortality

Chen

Liu

et al. 2021

Eur J Inflamm

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“…Although 30-day mortality (3.8%) in our study was lower than recent reports ( Artero et al, 2021 ), Our findings have shown that 71% and 68.8% of our sample underwent CCI after admission to ICU with COVID-19 pneumonia had a CURB-65 and PSI scores of 1–2 and 1-3, respectively; with a relatively high need, for CCI (18.7%). Hence the need for clinical models for COVID-19 pneumonia based on other outcomes modified by in-patient care as compared to mortality.…”

Section: Discussioncontrasting

confidence: 71%

External Validation and Recalibration of the CURB-65 and PSI for Predicting 30-Day Mortality and Critical Care Intervention in Multiethnic Patients with COVID-19

Elmoheen¹,

Abdelhafez²,

Salem³

et al. 2021

International Journal of Infectious Diseases

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Objectives To validate and recalibrate the CURB-65 and pneumonia severity index (PSI) in predicting 30-day mortality and critical care intervention (CCI) in a multiethnic population with COVID-19, along with evaluating both models in predicting CCI. Methods Retrospective data was collected for 1181 patients admitted to the largest hospital in Qatar with COVID-19 pneumonia. The area under the curve (AUC), calibration curves, and other metrics were bootstrapped to examine the performance of the models. Variables constituting the CURB-65 and PSI scores underwent further analysis using the Least Absolute Shrinkage and Selection Operator (LASSO) along with logistic regression to develop a model predicting CCI. Complex machine learning models were built for comparative analysis. Results The PSI performed better than CURB-65 in predicting 30-day mortality (AUC 0.83, 0.78 respectively), while CURB-65 outperformed PSI in predicting CCI (AUC 0.78, 0.70 respectively). The modified PSI/CURB-65 model (respiratory rate, oxygen saturation, hematocrit, age, sodium, and glucose) predicting CCI had excellent accuracy (AUC 0.823) and good calibration. Conclusions Our study recalibrated, externally validated the PSI and CURB-65 for predicting 30-day mortality and CCI, and developed a model for predicting CCI. Our tool can potentially guide clinicians in Qatar to stratify patients with COVID-19 pneumonia.

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“…In some studies in the literature on COVID-19 pneumonia conducted to evaluate the need for ICU treatment, the mortality of patients with a CURB-65 score of 3 was found to increase and based on other studies in which the CUB-65 cut off value was found to be ≥2.5 in terms of mortality and invasive mechanical ventilation requirement, patients with a CURB65 score of 3 were evaluated as patients requiring ICU treatment [ [24] , [25] , [26] , [27] ]. Relying on these findings, patients in this study were divided into two groups as ICU need and non-ICU need.…”

Section: Methodsmentioning

confidence: 99%

Soluble P-selectin as a potential diagnostic and prognostic biomarker for COVID-19 disease: A case-control study

et al. 2021

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Introduction To our knowledge, the diagnostic value of the sP-Selectin level in the diagnosis of COVID-19 disease has not yet been investigated. In this study, we aimed to assess this by evaluating the relationship between sP-Selectin level and the clinical severity of COVID-19 infections. Methods A total of 80 patients (50 with mild to moderate and 30 with severe COVID-19 pneumonia), and 60 non-symptomatic healthy volunteers participated in the study. Following serum isolation, sP-Selectin levels were assessed by Enzyme-Linked Immunosorbent Assay (ELISA) method. Results The serum sP-Selectin level was 1.7 ng/ml in the control group (1–3.78); 6.24 ng/ml (5.14–7.23) in mild-to-moderate pneumonia group; and 6.72 ng/ml (5.36–8.03) in the severe pneumonia group. Serum sP-Selectin levels in both mild-to-moderate pneumonia and severe pneumonia groups were found to be higher than the control group, with statistical significance ( p = 0.0001 and p = 0.0001, respectively). Receiver operating characteristic analysis (ROC) showed greater area under the curve (AUC) for the serum sP-Selectin levels of the COVID-19 patients (AUC = 0.913, 95% CI = 0.857–0.969; p = 0.0001). The serum sP-Selectin level was found to be 97.5% sensitive and 80% specific at 4.125 ng/ml level for diagnosis (p = 0.0001). The serum sP-Selectin level was found to be 76.9% sensitive and 51.9% specific at the level of 6.12 ng/ml ( p = 0.005) to predict the need for intensive care treatment. Conclusion This study showed that sP-Selectin can be used as a valuable biomarker in both diagnosing and predicting the need for intensive care treatment of COVID-19 infection.

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Severity scores in COVID-19 pneumonia: a multicenter, retrospective, cohort study

Cited by 6 publications

References 26 publications

Performance of CURB-65, PSI, and APACHE-II for predicting COVID-19 pneumonia severity and mortality

Performance of CURB-65, PSI, and APACHE-II for predicting COVID-19 pneumonia severity and mortality

External Validation and Recalibration of the CURB-65 and PSI for Predicting 30-Day Mortality and Critical Care Intervention in Multiethnic Patients with COVID-19

Soluble P-selectin as a potential diagnostic and prognostic biomarker for COVID-19 disease: A case-control study

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