Prognostic Value of Integrated Pulmonary Index (IPI) Value in Determining Pneumonia Severity in Patients Diagnosed with COVID-19 Pneumonia in the Emergency Department

Abstract

Objective: This study aimed to examine the predictive power regarding prognosis of the Integrated Pulmonary Index (IPI) values measured at admission for patients diagnosed with COVID-19 pneumonia in the emergency department. In addition, the correlation between CURB-65 and PSI scores and IPI values in COVID-19 pneumonia was also examined. Methods: The study was conducted between April 2020 and December 2020 as a prospective study. We evaluated respiratory function using IPI monitoring system that includes oxygen saturation, end-tidal CO2, respiratory rate, and pulse rate. For patients diagnosed with COVID-19 pneumonia in the emergency department, the IPI value was measured at the time of admission and PSI and CURB-65 scores were calculated. The predictive power of the IPI value in patients with clinical severity and the correlations between clinical severity and PSI, CURB-65 and IPI scores were examined. All of the data that was obtained during the study was recorded in the study form and evaluated using the IBM SPSS 22.0 statistical program in which P <0.05 was considered to be statistically significant. Results: A total of 81 patients were included in the study. When the severity of pneumonia was compared with the CURB-65, PSI and IPI values, a statistically significant difference was found between the clinical severity groups for all scores (p<0.001 for each score). Although the correlation between clinical severity, CURB-65 and PSI scores was positive and moderate (r:0.556 and r:0.613, respectively), the correlation between clinical severity and IPI value was found to be inverse and strong (r:0.824). While the IPI value was green, the sensitivity to predict mild pneumonia was 94.92%, and the specificity was 54.55%. Conclusion: Although all of the scores showed a significant correlation with clinical severity in patients with COVID-19 pneumonia, this correlation was moderate in PSI and CURB-65 scores, while there was a strong inverse correlation between IPI value and clinical severity. Considering the ease of use of the IPI value and its correlation with the clinic, we believe that it is more successful than CURB-65 and PSI scores in predicting clinical severity in patients with COVID-19 pneumonia.