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Background: Evidence of COVID-19 respiratory sequels is restricted and predisposing factors are not well studied more than two years passing pandemic. This study followed COVID-19 patients 12 weeks after discharge from hospital for respiratory sequels. Material(s) and Method(s): This was a prospective study on discharged COVID-19 patients in 2021, in Jahrom, Iran. Exposure was COVID-19 clinical features at hospitalization, including symptoms and physical examination and laboratory findings, and primary endpoint was 12-week lung sequel, being evaluated by a chest CT scan. Demographics and previous medical history were considered covariates. SPO2and CRP 6-week changes were followed as an early tool for prediction of 12-week lung sequel. Result(s): Totally, 383 participants (17 had sequels) with mean age of 57.43 18.03 years old (50.13% male) completed 12-week study follow-ups. Ninety-one (23.8%) subjects had an ICU admission history. SPO2% in 6th week was statistically significantly associated with a higher rate of 12-week sequelae (p<0.001). Also, patients having CT scan scores between 40% to 50% (p=0.012) and higher than 50% (p=0.040) had higher chance of experiencing lung sequelae than patients with CT scan score of below 40%, as well as having ICU admission history and lower SPO2% at 6th week of discharge. There was a statistically significant increasing trend of SPO2% (P<0.001) and a statistically significant decreasing trend of CRP levels (P<0.001), overall. SPO2% increase after 6 weeks was lower in participants with lung sequels than fully improved ones (P=0.002) and as well as total 12-week change in SPO2% (P=0.001). CRP changes in none of evaluated periods were different among study groups (P>0.05). Conclusion(s): Our results were in favor of closely following SPO2levels after patient discharge, while CRP assessment seems not helpful based on our results [GMJ.2023;12:e2695].Copyright © 2023 Shiraz University of Medical Sciences. All rights reserved.
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Objective: The goal of our study was to determine the prognostic value of CURB-65, Sequential Organ Failure Assessment (SOFA), pneumonia severity index (PSI), MuLBSTA, and Acute Physiology and Chronic Health Evaluation (APACHE) II upon admission in patients with coronavirus disease 2019 (COVID-19, as well as the prediction cut-off value for death regarding these parameters. Methods: This observational retrospective study was performed in COVID-19 triage in Peymaniyeh hospital in Jahrom in 2021. In order to calculate SOFA, APACHE II, PSI, MuLBSTA, and CURB-65, data were collected from patients who were selected by available sampling method from PCR-confirmed COVID-19 patients. Thirty-day mortality was assessed as the primary outcome. ROC analysis was conducted using the STATA software to evaluate the prognostic value of the scoring systems. DeLong test was utilized to compare AUC of scores using a web based tool. Results: Ninety-two patients were included in this study with the mean age of 51.02 ± 17.81 years (male to female ratio was 1:1). SOFA had an AUC of 0.656 (P = 0.130), but other indices had statistically significant values of AUC. Based on the comparison of the AUCs, SOFA was the worst scoring system in COVID-19 as it had significantly lower AUC than PSI and APACHE II (P < 0.05);while its comparison with MULBSTA and CURB65 was not statistically significant (P > 0.05). Conclusion: It seems that APACHE II and PSI are the best prognostic factors in our study with no statistical difference compared together (P > 0.05). The sensitivity of APACHE II and PSI was 0.857 with the specificity of 0.927 and 0.976, respectively. The optimal cut-off point was 13 and 50 for APACHE II and PSI, respectively. © 2023 The Author(s).