Evaluation of Mortality Risk with CURB-65 and PSI in Patients with and Without Geriatric COVID-19 Pneumonia.

Abstract

Aim: The evaluation and management of pneumonia resulting from the infections of coronavirus disease 2019 (COVID-19) urgently require assessing disease severity to decide on the hospital admission and determine the therapeutic needs and options. This study compared the effectiveness of the CURB-65 scoring system and pneumonia severity index (PSI) to evaluate the mortality risk in the geriatric group having COVID-19 pneumonia and with other non-COVID-19 pneumonia. Methods: 527 patients in ages 65 years or older, whose computerized tomography scans showed ground glass densities, were selected among 21,134 patients who applied for laboratory confirmation of COVID-19. All demographic, clinical, and laboratory data were retrospectively scanned, and selected patients having COVID-19 pneumonia or non-COVID-19 pneumonia were followed up. Results: The overall mortality rate among all patients was 25.6%, the ratio of the patients having COVID-19 pneumonia was 14.3%, and the ratio of patients having non-COVID-19 pneumonia was 29.2%. ROC analysis showed that PSI>group III among COVID-19 patients had an effective discriminative effectiveness in predicting mortality with 77.8% sensitivity, 73.2% specificity, PPV 32.6%, NPV 95.2% (AUC:0.800, 95% CI: 0.720–0.866; P<0.0001). In predicting mortality in COVID-19 pneumonia patients with a CURB-65 score >2, sensitivity was 66.7%, PPV 60% specificity, and NPV 94.3% (AUC: 0.857, 95% CI: 0.783–0.913; P<0.0001). Conclusions: For pneumonia patients with a PSI score greater than three and CURB-65 score greater than two, COVID-19 and non-COVID-19 infections are powerful scores in predicting mortality. Each scoring system has its advantages in stratifying geriatric patients on admission and hospitalization.