Reliability of the pneumonia severity score (PSI) index in patients diagnosed with COVID-19 pneumonia to determine outpatient discharge

Abstract

Objectives: Covid-19 infection, which has plagued the whole world, leads to deaths with a heavy pneumonia manifestation. Smoking, male gender and age stand out among the poor prognostic criteria of the disease. However, we still do not have a reliable scoring system for this disease. In this study, we aimed to find a reliable score at home discharge by using the Pneumonia severity index (PSI). Methods: Patients who came with suspected covid-19 in May were prospectively examined. The PSI scores of the patients at the time of admission to the emergency department were calculated. The PSI score of 161 patients included in our study was divided into 2 groups as 18-49 years of age (group 1) and 50 and above (group 2). The clinical course of these patients was followed for 30 days. Data were associated with oxygen supplementation, need for intensive care, and mortality. Results: PSI score was significantly higher in group 1 males than females (p < 0.001). There was no difference over 50 years old (p = 0.571). The length of stay of group 2 patients was found to be significantly higher (p = 0.041). This may make us think that the treatment process becomes more difficult with age. The PSI scores of the 53 male patients were in Class 1, and those of the 42 female patients were Class 1. Among the patients who had the risk of 2 or more in Class 2 who were over the age of 50, 10 needed nasal oxygen, and 3 of these were transferred to Intensive Care Unit. Only one patient died. Conclusions: Patients over the age of 50 can be hospitalized if their PSI score is above 70, while patients under 50 can be followed up with home treatment. Group 2 patients without any additional disease can be followed up by telemedicine method.