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

Abstract

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 January 28, 2020, to February 29, 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 ROC curve and multivariate COX-PH model to analyze 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, nonsurvivors were older and illustrated higher respiratory rate, neutrophil-to-lymphocyte ratio, D-dimer, and LDH, but lower SpO2 as well as impaired liver function, especially synthesis function. CURB-65 showed good performance for predicting in-hospital death (AUC 0.81, 95% CI 0.71 to 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(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.