Comparison of CURB-65 Pneumonia Severity Score, Quick COVID-19 Severity Index, and Brescia-COVID Respiratory Severity Scale in Emergently Hospitalized COVID-19 Patients with Pneumonia

Abstract

Objective: This study aimed to assess the performance of the CURB-65, the quick COVID-19 severity index (qCSI), and the Brescia-COVID respiratory severity scale (BCRSS) scores in predicting ICU (intensive care unit) hospitalization and in-hospital mortality in emergently hospitalized patients with COVID-19 pneumonia. Materials and Methods: We retrospectively reviewed the emergently hospitalized 258 patients with COVID-19 pneumonia consecutively. The required sample size was calculated to compare the areas under the two ROC (receiver operating characteristic) curves (AUC) using the MedCalc 20.0 program (MedCalc Software Ltd., Ostend, Belgium). In addition, we actualized ROC analyses of the CURB-65, the qCSI, and the BCRSS scores and compared the ROC curves of these three scores. Results: The median age of the patients was 73, and 63.6% (n=164) were male. Of 258 patients, 29.5% (n=76) were hospitalized in the intensive care unit (ICU), and 15.9% (n=41) died. The CURB-65 and the qCSI scores predicted ICU admission at a moderate level (p≤0.001; AUC values were 0.743 and 0.723, respectively). However, the predictive effect of the BCRSS score for ICU admission was lower (p≤0.001; AUC value was 0.667). The CURB-65 predicted in-hospital mortality at a moderate level (p≤0.001; AUC value was 0.762). However, the predictive effect of the qCSI and the BCRSS scores for in-hospital mortality were lower (p≤0.001 and p=0.012, respectively; AUC values were 0.655 and 0.612, respectively). Conclusion: The CURB-65 score predicted ICU hospitalization and in-hospital mortality better than the qCSI and the BCRSS scores. Also, the qCSI score predicted ICU admission better than the BCRSS score.The predictive effect of the BCRSS score was the lowest. We recommend future studies to evaluate the value and utility of COVID-19 risk classification models. Keywords: COVID-19, CURB-65, scoring systems