To analyze the clinical characteristics of Omicron COVID-19 pneumonia and compare the predictive performance of several scores on disease severity and mortality risk

Abstract

Abstract Background Around the world, coronavirus disease 2019 (COVID-19) is still widely spread. Finding an appropriate scoring system to predict the severity and prognosis of the disease will be help to carry out appropriate intervention as soon as possible and reduce the mortality. Therefore, it is important to analysis the clinical and laboratory characteristics of patients with Omicron COVID-19 pneumonia and discuss the role of several scoring systems in predicting the disease severity and mortality risk. Methods We retrospective collected the clinical data of 409 patients, who visited at the Third Affiliated Hospital of Anhui Medical University and confirmed as Omicron COVID-19 pneumonia between 1, December 2022 and 31, January 2023. Recorded the PSI, CURB‑65 and MuLBSTA score within 24 hours, evaluated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the receiver operating characteristic (AUROC) curve of each scoring model in predicting the severity and mortality risk of Omicron COVID-19 pneumonia, and then compared the predictive value of several scoring systems on the severity and prognosis of Omicron COVID-19 pneumonia. Results Median age of 409 patients was 78 years, the onset of disease was mainly characterized by fever, cough, expectoration, fatigue and digestive symptoms. Expectoration, fatigue, Glasgow coma scale (GCS) score, lactate dehydrogenase (LDH), procalcitonin (PCT), creatinine and complicated by acute respiratory distress syndrome (ARDS) were independent risk factors for the severity of the Omicron COVID-19 pneumonia, while age, oxygenation index, glucose, LDH, and complicated by septic shock were independent risk factors for the mortality of it. The CURB‑65, PSI and MulBSTA score with cutoff value as 1.5, 115.5, 10.5, respectively; the sensitivity for predicting severe disease was 65.9%, 63.8%, 79.7%, the specificity was 63.8%, 76.8%, 60.9%, and the AUROC was 0.707, 0.750, 0.728. The CURB‑65, PSI and MulBSTA score with cutoff value as 1.5,102.5,12.5, respectively, the sensitivity for predicting mortality risk was 83.3%, 96.3%, 70.4%, the specificity was 59.4%, 60.8%, 65.4%, and the AUROC was 0.787, 0.850, 0.736. Conclusion The patients we included are older, and the majority of them combined with underlying diseases, LDH is the independent risk factor of the disease severity and prognosis. PSI with better predictive value for both disease severity and mortality risk, and it could be used to predict the severity and mortality risk of Omicron COVID-19 pneumonia.