Assessment of risk scores in Covid-19.
Int J Clin Pract
; 75(12): e13705, 2021 Dec.
Article
em En
| MEDLINE
| ID: mdl-32931634
ABSTRACT
OBJECTIVE:
To analyse the accuracy of commonly used risk scores (PSI and CURB-65) in predicting mortality and need for ICU admission in Covid-19. MATERIAL ANDMETHODS:
Prospective study of patients diagnosed with Covid-19 pneumonia. Patients were followed until home discharge or death. PSI, CURB-65, SMART-COP and MuLBSTA severity scores were assessed on admission. Risk scores were related to mortality and ICU admission.RESULTS:
About 249 patients, 143 males (57.4%) were included. The mean age was 65.6 + 16.1 years. Factors associates with mortality in the multivariate analysis were age > 80 years (OR 13.9; 95% CI 3.8-51.1) (P = .000), lymphocytes < 800 (OR 2.9; CI 95% 1.1-7-9) (P = .040), confusion (OR 6.3; 95% CI 1.6-24.7) (P = .008) and NT-proBNP > 500 pg/mL (OR 10.1; 95% CI 1.1-63.1) (P = .039). In predicting mortality, the PSI score AUC 0.874 (95% CI 0.808-0.939) and the CURB-65 score AUC 0.852 (95% CI 0.794-0.909) were the ones that obtained the best results. In the need for ICU admission, the SMART-COP score AUC 0.749 (95% CI 0.695-0.820) and the MuLBSTA score AUC 0.777 (95% CI 0.713-0.840) were the ones that obtained better results, with significant differences with PSI and CURB-65. The scores with the lowest value for ICU admission prediction were PSI with AUC of 0.620 (95% CI 0.549-0.690) and CURB-65 with AUC of 0.604 (95% CI 0.528-0.680).CONCLUSIONS:
Prognosis scores routinely used for CAP (PSI and CURB-65) were good predictors for mortality in patients with Covid-19 CAP but not for need of hospitalisation or ICU admission. In the evaluation of Covid-19 pneumonia, we need scores that allow to decide the appropriate level of care.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pneumonia
/
Infecções Comunitárias Adquiridas
/
COVID-19
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
/
Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article