Comparison of Pneumonia Severity Indices, qCSI, 4C-Mortality Score and qSOFA in Predicting Mortality in Hospitalized Patients with COVID-19 Pneumonia.

This is a retrospective and observational study on 1511 patients with SARS-CoV-2, who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. 1511 patients, 879 male (58.17%) and 632 female (41.83%) with a mean age of 60.1 ± 14.7 were included in the study. Survivors and non-survivors groups were statistically compared with respect to survival, discharge, ICU admission and in-hospital death. Although gender was not statistically significant different between two groups, 80 (60.15%) of the patients who died were male. Mean age was 72.8 ± 11.8 in non-survivors vs. 59.9 ± 14.7 in survivors (p < 0.001). Overall in-hospital mortality was found to be 8.8% (133/1511 cases), and overall ICU admission was 10.85% (164/1511 cases). The PSI/PORT score of the non-survivors group was higher than that of the survivors group (144.38 ± 28.64 versus 67.17 ± 25.63, p < 0.001). The PSI/PORT yielding the highest performance was the best predictor for in-hospital mortality, since it incorporates the factors as advanced age and comorbidity (AUROC 0.971; % 95 CI 0.961-0.981). The use of A-DROP may also be preferred as an easier alternative to PSI/PORT, which is a time-consuming evaluation although it is more comprehensive.

Prognostic Performance of the CALL Score in Hospitalized Patients with COVID-19 Pneumonia

Objective: Scoring systems are frequently used to predict disease severity and mortality in many different clinical conditions. The prognostic significance of a new scoring system developed for patients who are hospitalized due to Coronavirus disease-2019 (COVID-19) pneumonia, which is named CALL that stands for comorbidity (C), age (A), lymphocyte count (L), and lactate dehydrogenase (LDH) (L), was evaluated. Methods: This is a retrospective and observational study on 582 patients who were hospitalized due to moderate or severe COVID-19 pneumonia after being diagnosed as positive using the real-time polymerase chain reaction testing. CALL scores were evaluated in the two groups of patients, namely the survivors and the non-survivors. Results: Among all patients, 339 (58.24%) were males and 272 (46.73%) were older than 60 years. Comorbidities were not found in 174 (29.89 %) patients, whereas 408 (70.11%) had one or more comorbidities, mainly hypertension (n=275, 47.25%), diabetes mellitus (n=192, 32.98%), and coronary artery disease (n=78, 13.4%). Class A consist of 113 (19.41%) patients (4-6 s), 219 (37.62%) in Class B (7-9 s), and 250 (42.95%) in Class C (10-13 s). In-hospital mortality was found to be 6% (35 cases). Only 1 (0.88%) patient in Class A and 27 (10.8%) in Class C were deceased. As a result, in-hospital mortality was observed as 27 patients in Class C and 1 in Class A. The receiver operating characteristic analysis was used to assess the performance of the CALL score;the area under the curve was 0.76 (95% confidence interval of 0.68-0.85). Using a cutoff value of 10 points, the sensitivity was 77% and specificity was 60% for predicting in-hospital mortality. Conclusion: CALL score was observed to be strongly related to in-hospital mortality. As a simple diagnostic measure, it may be used as a complementary score for the treatment planning and management of COVID-19 pneumonia in pandemic conditions. (English) [ FROM AUTHOR] Amaç: Hastalık şiddetinin belirlenmesi ve prognozun öngörülmesinde çeşitli skorlama sistemleri kullanılmaktadır. Mevcut çalışmada, Koronavirüs hastalığı-2019 (COVID-19) pnömonisinde yüksek riskli hastaların saptanması amacı ile geliştirilen, 4 parametreden oluşan ve CALL skor C: komorbidite, A: yaş, L: lenfosit sayısı ve L: laktat dehidrojenaz (LDH) olarak adlandırılan, yeni bir skor sisteminin sonucu öngörebilme yetisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: 1 Eylül 2020-31 Aralık 2020 tarihleri arasında yatarak tedavi gören, Ters transkripsiyon polimeraz zincir reaksiyonu testi ile doğrulanmış, orta ve ağır şiddetli COVID-19 pnömonisi olan hastaların tıbbi kayıtlarının retrospektif analizi yapıldı. Çalışmaya toplam 582 hasta dahil edildi. CALL skoru sonuçları sağ kalanlar ve kaybedilenler olmak üzere iki hasta grubu için karşılaştırıldı. Bulgular: 339 (%58,24) erkek hastanın olduğu çalışmada, 272 (%46,73) hastanın 60 yaş üzerinde olduğu saptandı. 174 (%29,89) hastada herhangi bir komorbidite bulunmazken 408 (%70,11) hastada bir veya daha fazla komorbidite olduğu gözlendi. Komorbiditeler arasında ilk üç sırada hipertansiyon (275, %47,25), diyabet (192, %32,98) ve koroner arter hastalığı (78, %13,4) yer almaktaydı. CALL skoru sınıflamasına göre;113 (%19,41) hasta sınıf A (4-6 puan), 219 (%37,62) hasta sınıf B (7-9 puan) ve 250 (%42,95) hasta sınıf C (10-13 puan) olarak kaydedildi. Sınıf A'da sadece 1 (%0,88) hastanın, sınıf C'de ise 27 (%10,8) hastanın kaybedildiği saptandı. Hastane içi mortalite oranı %6 (35 hasta) bulundu. Kaybedilen toplam 35 hasta değerlendirildiğinde;27 hastanın sınıf C, 7 hastanın sınıf B ve 1 hastanın sınıf A kategorisinde bulunduğu gözlendi. CALL skorun performansını değerlendirmek amacı ile kullanılan Receiver operating characteristics analizinde arena eğri altında 0,76 (%95 güven aralığı, 0,68-0,85) bulundu. Cutoff değeri 10 puan olarak kabul edildiğinde, CALL skorun hastane içi mortaliteyi öngörmede %77 duyarlılık ve %60 özgüllüğe sahip olduğu saptandı. Sonuç: CALL skorun hastane içi mortalite ile güçlü bir şekilde ilişkili olduğu gözlendi. CALL skoru, özellikle pandemi koşulları dikkate alındığında COVID-19 pnömonisinin tedavi yönetiminde basit, yardımcı ve tamamlayıcı bir skor olarak kullanılabilir. (Turkish) [ FROM AUTHOR] Copyright of Medical Journal of Bakirkoy is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Comparison of systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized patients with malignancy, and their influence on mortality from COVID-19.

INTRODUCTION: We evaluated several biological indicators based on inflammation and/or nutritional status, such as systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized COVID-19 patients with and without malignancies for a prognostic significance. METHODOLOGY: This is a retrospective and observational study on 186 patients with SARS-CoV-2, who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. 75 patients had various malignancies, and the rest (111), having a similar age and comorbidity profile based on propensity score matching, had no malignancy. RESULTS: None of the measures as neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, monocyte to lymphocyte ratio, SII, PNI or ANDC was found to be significantly different between two groups. Odds ratio for the mortality, OR 2.39 (%95 CI 1.80-3.16) was found to be significantly higher for the malignancy group, even though the duration of hospitalization was statistically similar for both groups. PNI was found to be significantly lower for deceased patients compared with survivors in the malignancy group. Contrarily, ANDC was found to be significantly higher for deceased patients in the malignancy group. CONCLUSIONS: PNI and ANDC have independent predictive power on determining the in-hospital death in COVID-19 malignancy cases. It is suggested that ANDC seems to be a more sensitive score than SII in COVID-19 cases with malignancies.