Severity Scores in COVID-19 Pneumonia: a Multicenter, Retrospective, Cohort Study

被引：44

作者：

Artero, Arturo ^{[1
]}

Madrazo, Manuel ^{[2
]}

Fernandez-Garces, Mar ^{[2
]}

Muino Miguez, Antonio ^{[3
]}

Gonzalez Garcia, Andres ^{[4
]}

Crestelo Vieitez, Anxela ^{[5
]}

Garcia Guijarro, Elena ^{[6
]}

Fonseca Aizpuru, Eva Maria ^{[7
]}

Garcia Gomez, Miriam ^{[8
]}

Areses Manrique, Maria ^{[9
]}

Martinez Cilleros, Carmen ^{[10
]}

Fidalgo Moreno, Maria del Pilar ^{[11
]}

Loureiro Amigo, Jose ^{[12
]}

Gil Sanchez, Ricardo ^{[13
]}

Rabadan Pejenaute, Elisa ^{[14
]}

Abella Vazquez, Lucy ^{[15
]}

Canizares Navarro, Ruth ^{[16
]}

Solis Marquinez, Marta Nataya ^{[17
]}

Carrasco Sanchez, Francisco Javier ^{[18
]}

Gonzalez Moraleja, Julio ^{[19
]}

Montero Rivas, Lorena ^{[20
]}

Escobar Sevilla, Joaquin ^{[21
]}

Martin Escalante, Maria Dolores ^{[22
]}

Gomez-Huelgas, Ricardo ^{[23
]}

Ramos-Rincon, Jose Manuel ^{[24
]}

机构：

[1] Univ Valencia, Dr Peset Univ Hosp, Internal Med Dept, Valencia, Spain

[2] Dr Peset Univ Hosp, Internal Med Dept, Avda Gaspar Aguilar 90, Valencia 46017, Spain

[3] Gregorio Maranon Univ Hosp, Internal Med Dept, Madrid, Spain

[4] Raman y Cajal Univ Hosp, Internal Med Dept, Madrid, Spain

[5] Royo Villanova Hosp, Internal Med Dept, Zaragoza, Spain

[6] Infanta Cristina Univ Hosp, Internal Med Dept, Madrid, Spain

[7] Cabuenes Hosp, Internal Med Dept, Gijon, Asturias, Spain

[8] Urduliz Alfredo Espinosa Hosp, Internal Med Dept, Urduliz, Vizcaya, Spain

[9] Santa Marina Hosp, Internal Med Dept, Bilbao, Spain

[10] HLA Moncloa Hosp, Internal Med Dept, Madrid, Spain

[11] Henares Hosp, Internal Med Dept, Madrid, Spain

[12] Moises Broggi Hosp, Internal Med Dept, Barcelona, Spain

[13] La Fe Univ Hosp, Internal Med Dept, Valencia, Spain

[14] San Pedro Hosp, Internal Med Dept, Logrono, La Rioja, Spain

[15] Ntra Sra Candelaria Univ Hosp, Internal Med Dept, Santa Cruz De Tenerife, Spain

[16] San Juan Alicante Univ Hosp, Internal Med Dept, Alicante, Spain

[17] San Agustin Univ Hosp, Internal Med Dept, Aviles, Asturias, Spain

[18] Juan Ramon Jimenez Hosp, Internal Med Dept, Huelva, Spain

[19] Virgen de la Salud Hosp, Internal Med Dept, Toledo, Spain

[20] Infanta Margarita Hosp, Internal Med Dept, Cordoba, Spain

[21] Virgen de la Nieves Univ Hosp, Internal Med Dept, Granada, Spain

[22] Costa del Sol Hosp, Internal Med Dept, Malaga, Spain

[23] Malaga Reg Univ Hosp, Internal Med Dept, Malaga, Spain

[24] Miguel Hernandez Univ Elche, Dept Clin Med, Alicante, Spain

来源：

JOURNAL OF GENERAL INTERNAL MEDICINE | 2021年 / 36卷 / 05期

关键词：

CURB-65; PSI; qSOFA; COVID-19; community-acquired pneumonia; COMMUNITY-ACQUIRED PNEUMONIA; IN-HOSPITAL MORTALITY; PREDICTING MORTALITY; CLINICAL-CRITERIA; SOFA SCORES; SEPSIS; VALIDATION; QSOFA; ACCURACY; DECISION;

D O I：

10.1007/s11606-021-06626-7

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background Identification of patients on admission to hospital with coronavirus infectious disease 2019 (COVID-19) pneumonia who can develop poor outcomes has not yet been comprehensively assessed. Objective To compare severity scores used for community-acquired pneumonia to identify high-risk patients with COVID-19 pneumonia. Design PSI, CURB-65, qSOFA, and MuLBSTA, a new score for viral pneumonia, were calculated on admission to hospital to identify high-risk patients for in-hospital mortality, admission to an intensive care unit (ICU), or use of mechanical ventilation. Area under receiver operating characteristics curve (AUROC), sensitivity, and specificity for each score were determined and AUROC was compared among them. Participants Patients with COVID-19 pneumonia included in the SEMI-COVID-19 Network. Key results We examined 10,238 patients with COVID-19. Mean age of patients was 66.6 years and 57.9% were males. The most common comorbidities were as follows: hypertension (49.2%), diabetes (18.8%), and chronic obstructive pulmonary disease (12.8%). Acute respiratory distress syndrome (34.7%) and acute kidney injury (13.9%) were the most common complications. In-hospital mortality was 20.9%. PSI and CURB-65 showed the highest AUROC (0.835 and 0.825, respectively). qSOFA and MuLBSTA had a lower AUROC (0.728 and 0.715, respectively). qSOFA was the most specific score (specificity 95.7%) albeit its sensitivity was only 26.2%. PSI had the highest sensitivity (84.1%) and a specificity of 72.2%. Conclusions PSI and CURB-65, specific severity scores for pneumonia, were better than qSOFA and MuLBSTA at predicting mortality in patients with COVID-19 pneumonia. Additionally, qSOFA, the simplest score to perform, was the most specific albeit the least sensitive.

引用

页码：1338 / 1345

页数：8

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