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External Validation and Recalibration of the CURB-65 and PSI for Predicting 30-Day Mortality and Critical Care Intervention in Multiethnic Patients with COVID-19.
Elmoheen, Amr; Abdelhafez, Ibrahim; Salem, Waleed; Bahgat, Mohamed; Elkandow, Ali; Tarig, Amina; Arshad, Nauman; Mohamed, Khoulod; Al-Hitmi, Maryam; Saad, Mona; Emam, Fatima; Taha, Samah; Bashir, Khalid; Azad, Aftab.
  • Elmoheen A; Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar; College of Medicine, QU Health, Qatar University, Doha, Qatar. Electronic address: aelmoheen@hamad.qa.
  • Abdelhafez I; College of Medicine, QU Health, Qatar University, Doha, Qatar.
  • Salem W; Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar; College of Medicine, QU Health, Qatar University, Doha, Qatar.
  • Bahgat M; Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar.
  • Elkandow A; Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar.
  • Tarig A; Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar.
  • Arshad N; Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar.
  • Mohamed K; College of Medicine, QU Health, Qatar University, Doha, Qatar.
  • Al-Hitmi M; College of Medicine, QU Health, Qatar University, Doha, Qatar.
  • Saad M; College of Medicine, QU Health, Qatar University, Doha, Qatar.
  • Emam F; College of Medicine, QU Health, Qatar University, Doha, Qatar.
  • Taha S; College of Medicine, QU Health, Qatar University, Doha, Qatar.
  • Bashir K; Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar; College of Medicine, QU Health, Qatar University, Doha, Qatar.
  • Azad A; Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar; College of Medicine, QU Health, Qatar University, Doha, Qatar.
Int J Infect Dis ; 111: 108-116, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-2113607
ABSTRACT

OBJECTIVES:

To validate and recalibrate the CURB-65 and pneumonia severity index (PSI) in predicting 30-day mortality and critical care intervention (CCI) in a multiethnic population with COVID-19, along with evaluating both models in predicting CCI.

METHODS:

Retrospective data was collected for 1181 patients admitted to the largest hospital in Qatar with COVID-19 pneumonia. The area under the curve (AUC), calibration curves, and other metrics were bootstrapped to examine the performance of the models. Variables constituting the CURB-65 and PSI scores underwent further analysis using the Least Absolute Shrinkage and Selection Operator (LASSO) along with logistic regression to develop a model predicting CCI. Complex machine learning models were built for comparative analysis.

RESULTS:

The PSI performed better than CURB-65 in predicting 30-day mortality (AUC 0.83, 0.78 respectively), while CURB-65 outperformed PSI in predicting CCI (AUC 0.78, 0.70 respectively). The modified PSI/CURB-65 model (respiratory rate, oxygen saturation, hematocrit, age, sodium, and glucose) predicting CCI had excellent accuracy (AUC 0.823) and good calibration.

CONCLUSIONS:

Our study recalibrated, externally validated the PSI and CURB-65 for predicting 30-day mortality and CCI, and developed a model for predicting CCI. Our tool can potentially guide clinicians in Qatar to stratify patients with COVID-19 pneumonia.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia / Community-Acquired Infections / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Int J Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia / Community-Acquired Infections / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Int J Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article