CURB-65 may serve as a useful prognostic marker in COVID-19 patients within Wuhan, China: a retrospective cohort study
CURB-65 may serve as a useful prognostic marker in COVID-19 patients within Wuhan, China: a retrospective cohort study
复制标题
DOI：
10.1017/s0950268820002368
复制
发表时间：
2020-10-01
影响因子：
4.2
通讯作者：
Zhang, Ping
中科院分区：
文献类型：
--
作者：
Guo, Jun;Zhou, Boda;Zhang, Ping
最近出现的由 SARS-CoV-2 引起的肺炎已在世界范围内迅速传播。不幸的是，尚未开发出可轻松用于初级保健或一般医疗机构的简化风险评分。本研究的目的是确定一个简化的风险评分，可轻松用于快速对重症 COVID-19 患者进行分类。本研究纳入了2020年1月28日至2月29日中国武汉协和医院西院区所有经实验室确诊的COVID-19重症和危重症成年患者。获得了临床数据和实验室结果。计算CURB-65肺炎评分。应用单变量逻辑回归探讨与院内死亡相关的危险因素。我们使用受试者工作特征曲线和多元COX-PH模型来分析院内死亡的危险因素。最终共有74名患者（31名死亡，43名幸存）纳入研究。我们观察到，与幸存者相比，非幸存者年龄较大，呼吸频率、中性粒细胞与淋巴细胞比率、D-二聚体和乳酸脱氢酶（LDH）较高，但 SpO(2) 较低，肝功能尤其是合成功能受损。 CURB-65 在预测院内死亡方面表现出良好的性能（曲线下面积 0.81，95% 置信区间 (CI) 0.71-0.91）。遏制-65。 2 可作为预测 COVID-19 重症患者院内死亡的临界值（敏感性 68%，特异性 81%，F1 评分 0.7）。 CURB-65（风险比（HR）1.61；95% CI 1.05-2.46）、LDH（HR 1.003；95% CI 1.001-1.004）和白蛋白（HR 0.9；95% CI 0.81-1）是重症COVID-19患者院内死亡的危险因素。我们的研究表明 CURB-65 可以作为 COVID-19 患者的有用预后标志物，可用于在初级保健或全科医疗环境中快速对重症患者进行分类。
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 SpO(2) 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 cutoff 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.