Objective: Coronavirus disease-2019 (COVID-19) pneumonia is a disease with a high mortality rate caused by the severe acute respiratory syndrome-coronavirus-2 virus. Therefore, it is essential to identify patients at risk for mortality. This study aims to determine the ability of pneumonia scores to predict mortality and correlation with laboratory parameters.
Material and Methods: A total of 312 pneumonia patients with positive polymerase chain reaction results were included in this single-center retrospective study conducted between 10.03.2020 and 10.06.2020. All data obtained from the hospital database, confusion, urea, respiratory, blood pressure, 65 or older (CURB-65) and Pneumonia Severity Index (PSI), scores were calculated. Receiver operator characteristics (ROC) curve analysis was performed for the prognostic value.
Results: The demographic data followed as; 175 (56.1%) of 312 patients were male and 137 (43.9%) were female; mean age was 58.2±16.1 years. The mortality rate was 16% (n=50). The length of hospital stay was 10.6±6.4 day. CURB-65, PSI, and PSI risk class was found to be higher in cases that resulted in mortality compared to those without mortality (p<0.001). CURB-65, PSI, PSI risk classification were positively correlated with, D-dimer, ferritin, and neutrophil lymphocyte ratio. The area under the ROC curve was 0.851 [95% confidence interval (CI): 0.803-0.899] for PSI, 0.833 (95% CI: 0.779-0.888) for PSI risk class score and 0.795 (95% CI: 0.725-0.865) for CURB-65. In determining mortality; optimal cut-off values were ≥1 for CURB-65 (sensitivity 86.0% specificity 61.1%), ≥86.5 for PSI (sensitivity 82%, specificity 70.6%), and ≥4 for PSI risk classification (sensitivity 76.0%, specificity 72.9%).
Conclusion: CURB-65, PSI, and PSI risk classifications were found eligible for use in COVID-19 and combining these scores with laboratory parameters can be useful to determine the prognosis.
Keywords: CURB-65, ferritin, D-dimer, NLR, COVID-19 pneumonia, PSI
