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CURB-65 plus hypoalbuminemia: a new score system for prediction of the in-hospital mortality risk in patients with SARS-CoV-2 pneumonia.
Oliva, Alessandra; Borrazzo, Cristian; Mascellino, Maria Teresa; Curtolo, Ambrogio; Al Ismail, Dania; Cancelli, Francesca; Galardo, Gioacchino; Bucci, Tommaso; Ceccarelli, Giancarlo; d'Ettorre, Gabriella; Pugliese, Francesco; Mastroianni, Claudio M; Venditti, Mario.
  • Oliva A; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome Italy.
  • Borrazzo C; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome Italy.
  • Mascellino MT; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome Italy.
  • Curtolo A; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome Italy.
  • Al Ismail D; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome Italy.
  • Cancelli F; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome Italy.
  • Galardo G; Medical Emergency Unit, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
  • Bucci T; Department of General Surgery, Surgical Specialties and Organ Transplantation "Paride Stefanini", Sapienza University of Rome, Rome, Italy.
  • Ceccarelli G; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome Italy.
  • d'Ettorre G; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome Italy.
  • Pugliese F; Anesthesiology and Intensive Care group, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
  • Mastroianni CM; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome Italy.
  • Venditti M; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome Italy.
Infez Med ; 29(3): 408-415, 2021.
Article in English | MEDLINE | ID: covidwho-1444695
ABSTRACT

INTRODUCTION:

There is the need of a simple but highly reliable score system for stratifying the risk of mortality and Intensive Care Unit (ICU) transfer in patients with SARS-CoV-2 pneumonia at the Emergency Room.

PURPOSE:

In this study, the ability of CURB-65, extended CURB-65, PSI and CALL scores and C-Reactive Protein (CRP) to predict intra-hospital mortality and ICU admission in patients with SARS-CoV-2 pneumonia were evaluated.

METHODS:

During March-May 2020, a retrospective, single-center study including all consecutive adult patients with diagnosis of SARS-CoV-2 pneumonia was conducted. Clinical, laboratory and radiological data as well as CURB-65, expanded CURB-65, PSI and CALL scores were calculated based on data recorded at hospital admission.

RESULTS:

Overall, 224 patients with documented SARS-CoV-2 pneumonia were included in the study. As for intrahospital mortality (24/224, 11%), PSI performed better than all the other tested scores, which showed lower AUC values (AUC=0.890 for PSI versus AUC=0.885, AUC=0.858 and AUC=0.743 for expanded CURB-65, CURB-65 and CALL scores, respectively). Of note, the addition of hypoalbuminemia to the CURB-65 score increased the prediction value of intra-hospital mortality (AUC=0.905). All the tested scores were less predictive for the need of ICU transfer (26/224, 12%), with the best AUC for extended CURB-65 score (AUC= 0.708).

CONCLUSION:

The addition of albumin level to the easy-to-calculate CURB-65 score at hospital admission is able to improve the quality of prediction of intra-hospital mortality in patients with SARS-CoV-2 pneumonia.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Language: English Journal: Infez Med Journal subject: Allergy and Immunology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Language: English Journal: Infez Med Journal subject: Allergy and Immunology Year: 2021 Document Type: Article