https://doi.org/10.4081/monaldi.2022.2054
Usefulness of CURB-65, pneumonia severity index and MuLBSTA in predicting COVID-19 mortality
Accepted: February 14, 2022
Supplementary: 204
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
The aim of our study is to evaluate the accuracy of CURB-65 and Pneumonia Severity Index (PSI), the most widely used scores for community acquired pneumonia, and MuLBSTA, a viral pneumonia score, in predicting 28-day mortality in Coronavirus Disease 2019 (COVID-19) pneumonia.We retrospectively collected clinical data of consecutive patients with laboratory-confirmed COVID-19 pneumonia admitted at Papa Giovanni XXIII Hospital from February 23rd to March 14th, 2020. We calculated at Emergency Department (ED) presentation CURB-65, PSI and MuLBSTA and we compared their performances in discriminating between survivors and non-survivors at 28 days. Among 431 hospitalized patients, the majority presented with hypoxic respiratory failure: median (interquartile range, IQR) PaO2/FiO2 ratio at admission was 228.6 (142.0-278.1). In the first 24 hours, 111 (27%) patients were administered low-flow oxygen cannula, 50 (12%) Venturi Mask, 95 (23%) non-rebreather mask, 106 (26%) non-invasive ventilation, 12 (3%) mechanical ventilation and 41 (9%) were not administered oxygen therapy. Mortality rate at 28-day was 35% (150/431). Between survivors and non-survivors, median (IQR) scores were, respectively, 1.0 (1.0-2.0) and 2.0 (2.0-3.0) for CURB-65 (p<0.001); 90.5 (76.0-105.5) and 115.0 (100.0-129.0) for PSI (p<0.001); 7.0 (5.0-10.0) and 11.0 (9.0-13.0) for MuLBSTA (p<0.001). Areas under the receiver operating characteristic curve (AUCs) for each score were, respectively, 0.725 (0.662-0.787), 0.776 (0.693-0.859) and 0.743 (0.680-0.806) (p>0,05). PSI and MuLBSTA did not show a better performance when compared to CURB-65. Although CURB-65, PSI and MuLBSTA scores are useful tools to discriminate between survivors and non-survivors in COVID-19 pneumonia, their diagnostic accuracy in discriminating 28-day mortality in COVID-19 pneumonia is moderate, as confirmed by AUCs <0.80, and there is a potential underestimation of disease severity in the low-risk classes. For this reason, they should not be recommended in ED to decide between inpatient and outpatient management in patients affected by COVID-19 pneumonia.
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Muhammad Ijaz, Muhammad Jaffar Khan, Jawad Khan, . Usama, Association of clinical characteristics of patients presenting with influenza like illness or severe acute respiratory illness with development of acute respiratory distress syndrome , Monaldi Archives for Chest Disease: Vol. 87 No. 1 (2017)
- Massimiliano Polastri, Lara Pisani, Andrea Dell'Amore, Stefano Nava, Revolving door respiratory patients: A rehabilitative perspective , Monaldi Archives for Chest Disease: Vol. 87 No. 3 (2017)
- Federico Raimondi, Stefano Centanni, Fabrizio Luppi, Stefano Aliberti, Francesco Blasi, Paola Rogliani, Claudio Micheletto, Marco Contoli, Alessandro Sanduzzi Zamparelli, Marialuisa Bocchino, Paolo Busatto, Luca Novelli, Simone Pappacena, Luca Malandrino, Giorgio Lorini, Greta Cairoli, Fabiano Di Marco, Respiratory rate-oxygenation index on the 3rd day is the best predictor of treatment failure in COVID-19 patients , Monaldi Archives for Chest Disease: Early Access
- S. Bertini, M. Picariello, M. Gorini, T. Renda, A. Augustynen, G. Villella, G. Misuri, N.M. Maluccio, R. Ginanni, D. Tozzi, A. Corrado, Telemonitoring in chronic ventilatory failure: a new model of survellaince, a pilot study , Monaldi Archives for Chest Disease: Vol. 77 No. 2 (2012): Pulmonary series
- Angel Estella, Usefulness of CURB-65 and Pneumonia Severity Index for Influenza A H1N1v pneumonia , Monaldi Archives for Chest Disease: Vol. 77 No. 3-4 (2012): Pulmonary series
- L. Barbano, E. Bertella, M. Vitacca, Episodic medical home interventions in severe bedridden Chronic Respiratory Failure patients: a 4 year retrospective study , Monaldi Archives for Chest Disease: Vol. 71 No. 3 (2009): Pulmonary series
- Gianfranco Beghi, Antonio De Tanti, Paolo Serafini, Chiara Bertolino, Antonietta Celentano, Graziella Taormina, Monitoring of hospital acquired pneumonia in patients with severe brain injury on first access to intensive neurological rehabilitation: First year of observation , Monaldi Archives for Chest Disease: Vol. 88 No. 1 (2018)
- Alice Biffi, Giulia Dei, Federica De Giacomi, Anna Stainer, Lorenzo Olmo Parma, Maria Rosa Pozzi, Paola Faverio, Alberto Pesci, Non-specific interstitial pneumonia and features of connective tissue disease: What are the consequences of a different point of view? , Monaldi Archives for Chest Disease: Vol. 88 No. 3 (2018)
- G. Caramori, M. Fabbri, D. Paioli, F. Falcone, C. Severino, G. Felisatti, O. Arar, I.M. Adcock, K. Fan Chung, P.J. Barnes, A. Ciaccia, A. Papi, Asthma is not a common cause of severe chronic respiratory failure in non-smokers: ALOT study , Monaldi Archives for Chest Disease: Vol. 63 No. 2 (2005): Pulmonary series
- Michele Vitacca, Luca Barbano, Daniele Colombo, Olivia Leoni, Enrico Guffanti, Prevalence and variability of use of home mechanical ventilators, positive airway pressure and oxygen devices in the Lombardy region, Italy , Monaldi Archives for Chest Disease: Vol. 88 No. 1 (2018)
You may also start an advanced similarity search for this article.
