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Pneumonia severity indices predict prognosis in coronavirus disease-2019.
Ucan, E S; Ozgen Alpaydin, A; Ozuygur, S S; Ercan, S; Unal, B; Sayiner, A A; Ergan, B; Gokmen, N; Savran, Y; Kilinc, O; Avkan Oguz, V.
  • Ucan ES; Department of Pulmonary Diseases, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
  • Ozgen Alpaydin A; Department of Pulmonary Diseases, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey. Electronic address: aylin.alpaydin@deu.edu.tr.
  • Ozuygur SS; Department of Pulmonary Diseases, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
  • Ercan S; Department of Pulmonary Diseases, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
  • Unal B; Department of Public Health, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
  • Sayiner AA; Department of Medical Microbiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
  • Ergan B; Department of Pulmonary Diseases, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
  • Gokmen N; Department of Anesthesiology and Reanimation, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
  • Savran Y; Department of Internal Medicine, Medicana International Izmir Hospital, Izmir, Turkey.
  • Kilinc O; Department of Pulmonary Diseases, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
  • Avkan Oguz V; Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
Respir Med Res ; 79: 100826, 2021 May.
Article in English | MEDLINE | ID: covidwho-1221020
Semantic information from SemMedBD (by NLM)
1. Laboratory Procedures USES TNFRSF11A protei
Subject
Laboratory Procedures
Predicate
USES
Object
TNFRSF11A protei
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Community acquired pneumonia PREDISPOSES COVID-19
Subject
Community acquired pneumonia
Predicate
PREDISPOSES
Object
COVID-19
4. Laboratory Procedures USES TNFRSF11A protein, human|TNFRSF11A
Subject
Laboratory Procedures
Predicate
USES
Object
TNFRSF11A protein, human|TNFRSF11A
5. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
6. Community acquired pneumonia PREDISPOSES COVID-19
Subject
Community acquired pneumonia
Predicate
PREDISPOSES
Object
COVID-19
ABSTRACT

BACKGROUND:

Early recognition of the severe illness is critical in coronavirus disease-19 (COVID-19) to provide best care and optimize the use of limited resources.

OBJECTIVES:

We aimed to determine the predictive properties of common community-acquired pneumonia (CAP) severity scores and COVID-19 specific indices.

METHODS:

In this retrospective cohort, COVID-19 patients hospitalized in a teaching hospital between 18 March-20 May 2020 were included. Demographic, clinical, and laboratory characteristics related to severity and mortality were measured and CURB-65, PSI, A-DROP, CALL, and COVID-GRAM scores were calculated as defined previously in the literature. Progression to severe disease and in-hospital/overall mortality during the follow-up of the patients were determined from electronic records. Kaplan-Meier, log-rank test, and Cox proportional hazard regression model was used. The discrimination capability of pneumonia severity indices was evaluated by receiver-operating-characteristic (ROC) analysis.

RESULTS:

Two hundred ninety-eight patients were included in the study. Sixty-two patients (20.8%) presented with severe COVID-19 while thirty-one (10.4%) developed severe COVID-19 at any time from the admission. In-hospital mortality was 39 (13.1%) while the overall mortality was 44 (14.8%). The mortality in low-risk groups that were identified to manage outside the hospital was 0 in CALL Class A, 1.67% in PSI low risk, and 2.68% in CURB-65 low-risk. However, the AUCs for the mortality prediction in COVID-19 were 0.875, 0.873, 0.859, 0.855, and 0.828 for A-DROP, PSI, CURB-65, COVID-GRAM, and CALL scores respectively. The AUCs for the prediction of progression to severe disease was 0.739, 0.711, 0,697, 0.673, and 0.668 for CURB-65, CALL, PSI, COVID-GRAM, A-DROP respectively. The hazard ratios (HR) for the tested pneumonia severity indices demonstrated that A-DROP and CURB-65 scores had the strongest association with mortality, and PSI, and COVID-GRAM scores predicted mortality independent from age and comorbidity.

CONCLUSION:

Community-acquired pneumonia (CAP) scores can predict in COVID-19. The indices proposed specifically to COVID-19 work less than nonspecific scoring systems surprisingly. The CALL score may be used to decide outpatient management in COVID-19.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / COVID-19 Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Respir Med Res Year: 2021 Document Type: Article Affiliation country: J.resmer.2021.100826

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / COVID-19 Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Respir Med Res Year: 2021 Document Type: Article Affiliation country: J.resmer.2021.100826