CURB-65 may serve as a useful prognostic marker in COVID-19 patients within Wuhan, China: a retrospective cohort study

• Published in: Epidemiology & Infection 2020-10, Vol.148, p.e241-e241, Article e241
• Main Authors: Guo, Jun, Zhou, Boda, Zhu, Mengen, Yuan, Yifang, Wang, Qian, Zhou, Hua, Wang, Xiaohui, Lv, Tingting, Li, Siyuan, Liu, Peng, Yang, Ying, He, Ping, Zhang, Ping
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Albumins; Betacoronavirus; Biomarkers; Blood pressure; Cohort analysis; Confidence intervals; Coronavirus Infections - mortality; Coronaviruses; COVID-19; Data collection; Death; Diabetes; Dimers; Dyspnea; Female; Fever; Health care; Hospitals; Humans; Hypertension; L-Lactate dehydrogenase; L-Lactate Dehydrogenase - blood; Laboratories; Lactate dehydrogenase; Lactic acid; Leukocytes (neutrophilic); Logistic Models; Lymphocytes; Male; Markers; Medical prognosis; Medical records; Medical research; Middle Aged; Mortality; Original Paper; Oxygen saturation; Pandemics; Patients; Performance prediction; Pneumonia; Pneumonia - mortality; Pneumonia, Viral - mortality; Primary care; Prognosis; Respiration; Respiratory rate; Retrospective Studies; Risk analysis; Risk factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Survival
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268820002368

A recently developed pneumonia caused by SARS-CoV-2 has quickly spread across the world. Unfortunately, a simplified risk score that could easily be used in primary care or general practice settings has not been developed. The objective of this study is to identify a simplified risk score that could easily be used to quickly triage severe COVID-19 patients. All severe and critical adult patients with laboratory-confirmed COVID-19 on the West campus of Union Hospital, Wuhan, China, from 28 January 2020 to 29 February 2020 were included in this study. Clinical data and laboratory results were obtained. CURB-65 pneumonia score was calculated. Univariate logistic regressions were applied to explore risk factors associated with in-hospital death. We used the receiver operating characteristic curve and multivariate COX-PH model to analyse risk factors for in-hospital death. A total of 74 patients (31 died, 43 survived) were finally included in the study. We observed that compared with survivors, non-survivors were older and illustrated higher respiratory rate, neutrophil-to-lymphocyte ratio, D-dimer and lactate dehydrogenase (LDH), but lower SpO2 as well as impaired liver function, especially synthesis function. CURB-65 showed good performance for predicting in-hospital death (area under curve 0.81, 95% confidence interval (CI) 0.71–0.91). CURB-65 ⩾ 2 may serve as a cut-off value for prediction of in-hospital death in severe patients with COVID-19 (sensitivity 68%, specificity 81%, F1 score 0.7). CURB-65 (hazard ratio (HR) 1.61; 95% CI 1.05–2.46), LDH (HR 1.003; 95% CI 1.001–1.004) and albumin (HR 0.9; 95% CI 0.81–1) were risk factors for in-hospital death in severe patients with COVID-19. Our study indicates CURB-65 may serve as a useful prognostic marker in COVID-19 patients, which could be used to quickly triage severe patients in primary care or general practice settings.