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Comparison of the effectiveness of the quick COVID-19 severity index and the COVID-19 gram critical illness risk score in identifying critical patients with COVID-19

Yıl 2024, Cilt: 2 Sayı: 3, 85 - 92, 25.09.2024
https://doi.org/10.61678/bursamed.1505472

Öz

Objectives: This study aimed to compare the effectiveness of the Quick COVID-19 Severity Index (qCSI) and the COVID-GRAM Critical Illness Risk Score (CGCIRS) in identifying critically ill patients with COVID-19 admitted to the emergency department of a tertiary hospital.
Methods: Patients over 18 years of age with a positive PCR test who presented to the Emergency Department of Bursa Yüksek İhtisas Training and Research Hospital between 15.03.2020 and 15.03.2021 with COVID-19 findings were retrospectively included in the study. Mortality, qCSI (respiratory rate per minute, oxygen saturation, oxygen demand per minute), and CGCIRS (x-ray abnormality, age, hemoptysis, dyspnea, impaired consciousness, comorbid disease, presence of cancer, neutrophil/lymphocyte ratio, lactate dehydrogenase (LDH) value, direct bilirubin value) were investigated within 1, 7 and 28 days.
Results: A total of 1499 patients with a positive COVID-19 PCR test were included in the study. Invasive mechanical ventilation was performed in 44 (2.9%) and non-invasive mechanical ventilation in 63 (4.2%) patients. 57 (3.8%) patients were hospitalized in the intensive care unit (ICU). Mortality occurred in the first 24 hours in 1 (0.1%) and 28 days in 41 (2.7%) patients. Having comorbidities, use of 10 lt/min oxygen, use of high flow oxygen, need for non-invasive and invasive mechanical ventilation, and need for ICU were found to increase 28-day mortality significantly. The qCSI and CGCIRS were found to be significantly different in patients who developed 28-day mortality with qCSI and CGCIRS, respectively (p<0.001), (p<0.001). In the ROC analysis for 28-day mortality, the area under the curve (AUC) value of qCSI was 0.966 [(95% CI: 0.934-0.998), (p<0.001)] and the AUC value of CGCIRS was 0.971 [(95% CI: 0.959-0.983), (p<0.001)]. qCSI had a sensitivity of 97.6% and specificity of 84% with a cut-off value of 4.5 for 28-day mortality; CGCIRS had a sensitivity of 95.1% and specificity of 91.2% with a cut-off value of 116.5 for 28-day mortality.
Conclusions: This study demonstrated that both qCSI and CGCIRS have significant predictive capabilities in identifying critical Covid-19 patients over a 28-day period. These scores are valuable for early identification and appropriate management of critically ill patients in the emergency department.

Etik Beyan

The study was conducted with the protocol numbered 2011-KAEK-25 2021/02-07 approved by the Bursa High Specialization Training and Research Hospital Clinical Research Ethics Committee.

Destekleyen Kurum

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Kaynakça

  • Vabret N, Britton GJ, Gruber C, Hegde S, Kim J, Kuksin M, Levantovsky R, Malle L, Moreira A, Park MD, Pia L, Risson E, Saffern M, Salomé B, Esai Selvan M, Spindler MP, Tan J, van der Heide V, Gregory JK, Alexandropoulos K, Bhardwaj N, Brown BD, Greenbaum B, Gümüş ZH, Homann D, Horowitz A, Kamphorst AO, Curotto de Lafaille MA, Mehandru S, Merad M, Samstein RM; Sinai Immunology Review Project. Immunology of COVID-19: Current State of the Science. Immunity. 2020 Jun 16;52(6):910-941. doi: 10.1016/j.immuni.2020.05.002.
  • Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020 Mar;55(3):105924. doi: 10.1016/j.ijantimicag.2020.105924.
  • Khari S, Abadi ASA, Pazokian M, Yousefifard M. CURB-65, qSOFA, and SIRS Criteria in Predicting In-Hospital Mortality of Critically Ill COVID-19 Patients; a Prognostic Accuracy Study. Arch Acad Emerg Med 2022;10(1): e36. doi: 10.22037/aaem.v10i1.1565
  • Haimovich AD, Ravindra NG, Stoytchev S, Young HP, Wilson FP, van Dijk D, Schulz WL, Taylor RA. Development and Validation of the Quick COVID-19 Severity Index: A Prognostic Tool for Early Clinical Decompensation. Ann Emerg Med. 2020 Oct;76(4):442-453. doi: 10.1016/j.annemergmed.2020.07.022.
  • Mission RotW-CJ, (COVID-19) oCD. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19): 2020 Report. Available from: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19- final-report.pdf.
  • Liang W, Liang H, Ou L, Chen B, Chen A, Li C, Li Y, Guan W, Sang L, Lu J, Xu Y, Chen G, Guo H, Guo J, Chen Z, Zhao Y, Li S, Zhang N, Zhong N, He J; China Medical Treatment Expert Group for COVID-19. Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19. JAMA Intern Med. 2020 Aug 1;180(8):1081-1089. doi: 10.1001/jamainternmed.2020.2033.
  • Abate BB, Kassie AM, Kassaw MW, Aragie TG, Masresha SA. Sex difference in coronavirus disease (COVID-19): a systematic review and meta-analysis. BMJ Open. 2020 Oct 6;10(10):e040129. doi: 10.1136/bmjopen-2020-040129.
  • Fang X, Li S, Yu H, Wang P, Zhang Y, Chen Z, Li Y, Cheng L, Li W, Jia H, Ma X. Epidemiological, comorbidity factors with severity and prognosis of COVID-19: a systematic review and meta-analysis. Aging (Albany NY). 2020 Jul 13;12(13):12493-12503. doi: 10.18632/aging.103579.
  • Sezgin B. Comparison of the efficiency of D-dimer / lymphocyte ratio and CURB-65 in determination of the prognosis of the patients applied to emergency department with COVID-19 pneumonia. https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp2021.
  • Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, Shi J, Zhou M, Wu B, Yang Z, Zhang C, Yue J, Zhang Z, Renz H, Liu X, Xie J, Xie M, Zhao J. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020 Jul;146(1):110-118. doi: 10.1016/j.jaci.2020.04.006.
  • Sagnelli C, Celia B, Monari C, Cirillo S, De Angelis G, Bianco A, Coppola N. Management of SARS-CoV-2 pneumonia. J Med Virol. 2021 Mar;93(3):1276-1287. doi: 10.1002/jmv.26470.
  • Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054-1062. doi: 10.1016/S0140-6736(20)30566-3. Epub 2020 Mar 11. Erratum in: Lancet. 2020 Mar 28;395(10229):1038. doi: 10.1016/S0140-6736(20)30606-1. Erratum in: Lancet. 2020 Mar 28;395(10229):1038. doi: 10.1016/S0140-6736(20)30638-3.
  • Zhou Y, Yang Q, Chi J, Dong B, Lv W, Shen L, Wang Y. Comorbidities and the risk of severe or fatal outcomes associated with coronavirus disease 2019: A systematic review and meta-analysis. Int J Infect Dis. 2020 Oct;99:47-56. doi: 10.1016/j.ijid.2020.07.029.
  • Khan MMA, Khan MN, Mustagir MG, Rana J, Islam MS, Kabir MI. Effects of underlying morbidities on the occurrence of deaths in COVID-19 patients: A systematic review and meta-analysis. J Glob Health. 2020 Dec;10(2):020503. doi: 10.7189/jogh.10.020503.
  • Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, Holguin-Rivera Y, Escalera-Antezana JP, Alvarado-Arnez LE, Bonilla-Aldana DK, Franco-Paredes C, Henao-Martinez AF, Paniz-Mondolfi A, Lagos-Grisales GJ, Ramírez-Vallejo E, Suárez JA, Zambrano LI, Villamil-Gómez WE, Balbin-Ramon GJ, Rabaan AA, Harapan H, Dhama K, Nishiura H, Kataoka H, Ahmad T, Sah R; Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19). Electronic address: https://www.lancovid.org. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020 Mar-Apr;34:101623. doi: 10.1016/j.tmaid.2020.101623.
  • Satici C, Demirkol MA, Sargin Altunok E, Gursoy B, Alkan M, Kamat S, Demirok B, Surmeli CD, Calik M, Cavus Z, Esatoglu SN. Performance of pneumonia severity index and CURB-65 in predicting 30-day mortality in patients with COVID-19. Int J Infect Dis. 2020 Sep;98:84-89. doi: 10.1016/j.ijid.2020.06.038.
  • Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, Zhang Z. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020 Jun;18(6):1324-1329. doi: 10.1111/jth.14859.
  • Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24. Erratum in: Lancet. 2020 Feb 15;395(10223):496. doi: 10.1016/S0140-6736(20)30252-X.
  • Izcovich A, Ragusa MA, Tortosa F, Marzio MAL, Agnoletti C, Bengolea A, Ceirano A, Espinosa F, Saavedra E, Sanguine V, Tassara A, Cid C, Catalano HN, Agarwal A, Foroutan F, Rada G. Correction: Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review. PLoS One. 2022 May 26;17(5):e0269291. doi: 10.1371/journal.pone.0269291. Erratum for: PLoS One. 2020 Nov 17;15(11):e0241955. doi: 10.1371/journal.pone.0241955.
  • Shi Y, Pandita A, Hardesty A, McCarthy M, Aridi J, Weiss ZF, et al. , Validation of pneumonia prognostic scores in a statewide cohort of hospitalised patients with COVID-19. Int J Clin Pract, 2021;75(3):e13926. doi: 10.1111/ijcp.13926
  • Armiñanzas C, Arnaiz de Las Revillas F, Gutiérrez Cuadra M, Arnaiz A, Fernández Sampedro M, González-Rico C, Ferrer D, Mora V, Suberviola B, Latorre M, Calvo J, Olmos JM, Cifrián JM, Fariñas MC. Usefulness of the COVID-GRAM and CURB-65 scores for predicting severity in patients with COVID-19. Int J Infect Dis. 2021 Jul;108:282-288. doi: 10.1016/j.ijid.2021.05.048.
  • Rodriguez-Nava G, Yanez-Bello MA, Trelles-Garcia DP, Chung CW, Friedman HJ, Hines DW. Performance of the quick COVID-19 severity index and the Brescia-COVID respiratory severity scale in hospitalized patients with COVID-19 in a community hospital setting. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. 2021;102:571-576. doi: 10.1016/j. ijid.2020.11.003.
  • Rod JE, Trespalacios OO, Ramirez JC. A brief-review of the risk factors for covid-19 severity. Rev Saude Publica. 2020;54:60 doi: 10.11606/s1518-8787.2020054002481
Yıl 2024, Cilt: 2 Sayı: 3, 85 - 92, 25.09.2024
https://doi.org/10.61678/bursamed.1505472

Öz

Kaynakça

  • Vabret N, Britton GJ, Gruber C, Hegde S, Kim J, Kuksin M, Levantovsky R, Malle L, Moreira A, Park MD, Pia L, Risson E, Saffern M, Salomé B, Esai Selvan M, Spindler MP, Tan J, van der Heide V, Gregory JK, Alexandropoulos K, Bhardwaj N, Brown BD, Greenbaum B, Gümüş ZH, Homann D, Horowitz A, Kamphorst AO, Curotto de Lafaille MA, Mehandru S, Merad M, Samstein RM; Sinai Immunology Review Project. Immunology of COVID-19: Current State of the Science. Immunity. 2020 Jun 16;52(6):910-941. doi: 10.1016/j.immuni.2020.05.002.
  • Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020 Mar;55(3):105924. doi: 10.1016/j.ijantimicag.2020.105924.
  • Khari S, Abadi ASA, Pazokian M, Yousefifard M. CURB-65, qSOFA, and SIRS Criteria in Predicting In-Hospital Mortality of Critically Ill COVID-19 Patients; a Prognostic Accuracy Study. Arch Acad Emerg Med 2022;10(1): e36. doi: 10.22037/aaem.v10i1.1565
  • Haimovich AD, Ravindra NG, Stoytchev S, Young HP, Wilson FP, van Dijk D, Schulz WL, Taylor RA. Development and Validation of the Quick COVID-19 Severity Index: A Prognostic Tool for Early Clinical Decompensation. Ann Emerg Med. 2020 Oct;76(4):442-453. doi: 10.1016/j.annemergmed.2020.07.022.
  • Mission RotW-CJ, (COVID-19) oCD. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19): 2020 Report. Available from: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19- final-report.pdf.
  • Liang W, Liang H, Ou L, Chen B, Chen A, Li C, Li Y, Guan W, Sang L, Lu J, Xu Y, Chen G, Guo H, Guo J, Chen Z, Zhao Y, Li S, Zhang N, Zhong N, He J; China Medical Treatment Expert Group for COVID-19. Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19. JAMA Intern Med. 2020 Aug 1;180(8):1081-1089. doi: 10.1001/jamainternmed.2020.2033.
  • Abate BB, Kassie AM, Kassaw MW, Aragie TG, Masresha SA. Sex difference in coronavirus disease (COVID-19): a systematic review and meta-analysis. BMJ Open. 2020 Oct 6;10(10):e040129. doi: 10.1136/bmjopen-2020-040129.
  • Fang X, Li S, Yu H, Wang P, Zhang Y, Chen Z, Li Y, Cheng L, Li W, Jia H, Ma X. Epidemiological, comorbidity factors with severity and prognosis of COVID-19: a systematic review and meta-analysis. Aging (Albany NY). 2020 Jul 13;12(13):12493-12503. doi: 10.18632/aging.103579.
  • Sezgin B. Comparison of the efficiency of D-dimer / lymphocyte ratio and CURB-65 in determination of the prognosis of the patients applied to emergency department with COVID-19 pneumonia. https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp2021.
  • Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, Shi J, Zhou M, Wu B, Yang Z, Zhang C, Yue J, Zhang Z, Renz H, Liu X, Xie J, Xie M, Zhao J. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020 Jul;146(1):110-118. doi: 10.1016/j.jaci.2020.04.006.
  • Sagnelli C, Celia B, Monari C, Cirillo S, De Angelis G, Bianco A, Coppola N. Management of SARS-CoV-2 pneumonia. J Med Virol. 2021 Mar;93(3):1276-1287. doi: 10.1002/jmv.26470.
  • Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054-1062. doi: 10.1016/S0140-6736(20)30566-3. Epub 2020 Mar 11. Erratum in: Lancet. 2020 Mar 28;395(10229):1038. doi: 10.1016/S0140-6736(20)30606-1. Erratum in: Lancet. 2020 Mar 28;395(10229):1038. doi: 10.1016/S0140-6736(20)30638-3.
  • Zhou Y, Yang Q, Chi J, Dong B, Lv W, Shen L, Wang Y. Comorbidities and the risk of severe or fatal outcomes associated with coronavirus disease 2019: A systematic review and meta-analysis. Int J Infect Dis. 2020 Oct;99:47-56. doi: 10.1016/j.ijid.2020.07.029.
  • Khan MMA, Khan MN, Mustagir MG, Rana J, Islam MS, Kabir MI. Effects of underlying morbidities on the occurrence of deaths in COVID-19 patients: A systematic review and meta-analysis. J Glob Health. 2020 Dec;10(2):020503. doi: 10.7189/jogh.10.020503.
  • Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, Holguin-Rivera Y, Escalera-Antezana JP, Alvarado-Arnez LE, Bonilla-Aldana DK, Franco-Paredes C, Henao-Martinez AF, Paniz-Mondolfi A, Lagos-Grisales GJ, Ramírez-Vallejo E, Suárez JA, Zambrano LI, Villamil-Gómez WE, Balbin-Ramon GJ, Rabaan AA, Harapan H, Dhama K, Nishiura H, Kataoka H, Ahmad T, Sah R; Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19). Electronic address: https://www.lancovid.org. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020 Mar-Apr;34:101623. doi: 10.1016/j.tmaid.2020.101623.
  • Satici C, Demirkol MA, Sargin Altunok E, Gursoy B, Alkan M, Kamat S, Demirok B, Surmeli CD, Calik M, Cavus Z, Esatoglu SN. Performance of pneumonia severity index and CURB-65 in predicting 30-day mortality in patients with COVID-19. Int J Infect Dis. 2020 Sep;98:84-89. doi: 10.1016/j.ijid.2020.06.038.
  • Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, Zhang Z. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020 Jun;18(6):1324-1329. doi: 10.1111/jth.14859.
  • Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24. Erratum in: Lancet. 2020 Feb 15;395(10223):496. doi: 10.1016/S0140-6736(20)30252-X.
  • Izcovich A, Ragusa MA, Tortosa F, Marzio MAL, Agnoletti C, Bengolea A, Ceirano A, Espinosa F, Saavedra E, Sanguine V, Tassara A, Cid C, Catalano HN, Agarwal A, Foroutan F, Rada G. Correction: Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review. PLoS One. 2022 May 26;17(5):e0269291. doi: 10.1371/journal.pone.0269291. Erratum for: PLoS One. 2020 Nov 17;15(11):e0241955. doi: 10.1371/journal.pone.0241955.
  • Shi Y, Pandita A, Hardesty A, McCarthy M, Aridi J, Weiss ZF, et al. , Validation of pneumonia prognostic scores in a statewide cohort of hospitalised patients with COVID-19. Int J Clin Pract, 2021;75(3):e13926. doi: 10.1111/ijcp.13926
  • Armiñanzas C, Arnaiz de Las Revillas F, Gutiérrez Cuadra M, Arnaiz A, Fernández Sampedro M, González-Rico C, Ferrer D, Mora V, Suberviola B, Latorre M, Calvo J, Olmos JM, Cifrián JM, Fariñas MC. Usefulness of the COVID-GRAM and CURB-65 scores for predicting severity in patients with COVID-19. Int J Infect Dis. 2021 Jul;108:282-288. doi: 10.1016/j.ijid.2021.05.048.
  • Rodriguez-Nava G, Yanez-Bello MA, Trelles-Garcia DP, Chung CW, Friedman HJ, Hines DW. Performance of the quick COVID-19 severity index and the Brescia-COVID respiratory severity scale in hospitalized patients with COVID-19 in a community hospital setting. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. 2021;102:571-576. doi: 10.1016/j. ijid.2020.11.003.
  • Rod JE, Trespalacios OO, Ramirez JC. A brief-review of the risk factors for covid-19 severity. Rev Saude Publica. 2020;54:60 doi: 10.11606/s1518-8787.2020054002481
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Acil Tıp
Bölüm Research Articles
Yazarlar

Büşra Demir 0009-0005-1322-1819

Mehmet Oğuzhan Ay 0000-0003-1061-5327

Yeşim İşler 0000-0002-6389-5361

Halil Kaya 0000-0003-2005-6100

Melih Yüksel 0000-0002-0793-3693

Yayımlanma Tarihi 25 Eylül 2024
Gönderilme Tarihi 26 Haziran 2024
Kabul Tarihi 5 Eylül 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 2 Sayı: 3

Kaynak Göster

EndNote Demir B, Ay MO, İşler Y, Kaya H, Yüksel M (01 Eylül 2024) Comparison of the effectiveness of the quick COVID-19 severity index and the COVID-19 gram critical illness risk score in identifying critical patients with COVID-19. Journal of Bursa Faculty of Medicine 2 3 85–92.

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