Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France; Center for Epidemiology and Population Health, INSERM U1018, Villejuif, France.
Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France.
J Infect. 2020 Sep;81(3):e96-e98. doi: 10.1016/j.jinf.2020.05.049. Epub 2020 May 29.
The CURB-65 is a severity score to predict mortality secondary to community acquired pneumonia and is widely used to identify patients who can be managed as outpatients. However, whether CURB-65 can be applicable to COVID-19 patients for the decision of outpatient treatment is still unknown.
We conducted a retrospective single-centre study assessing the performance of the CURB-65 to predict the risk of poor outcome, defined as the need for mechanical ventilation and/or death, among patients hospitalized for COVID-19. The association between the CURB-65 and the outcome was assessed by a univariable Cox proportional hazard regression model.
A total of 279 patients were hospitalized between March 15 and April 14, 2020. According to the CURB-65, 171 (61.3%) patients were considered at low risk (CURB-65 01), 66 (23.7%) at intermediate risk (CURB-65=2), and 42 (15.1%) had high risk of 30-day mortality (CURB-65 35). During the study period, 88 (31.5%) patients had a poor outcome. The CURB-65 was strongly associated with a poor outcome (P <0.001). However, among patients with a CURB-65 of 01, thus considered at low risk, 36/171 (21.1%) had a poor outcome.
Our study suggests that the applicability of CURB-65 to guide the decision of inpatient or outpatient care is scarce, as it does not safely identify patients who could be managed as outpatients.
CURB-65 是一种用于预测社区获得性肺炎继发死亡率的严重程度评分，广泛用于识别可门诊管理的患者。然而，CURB-65 是否可适用于 COVID-19 患者以用于门诊治疗决策尚不清楚。
我们进行了一项回顾性单中心研究，评估 CURB-65 预测 COVID-19 住院患者不良结局（定义为需要机械通气和/或死亡）风险的能力。通过单变量 Cox 比例风险回归模型评估 CURB-65 与结局之间的关联。
2020 年 3 月 15 日至 4 月 14 日期间共收治了 279 例患者。根据 CURB-65，171 例（61.3%）患者被认为低危（CURB-65 01），66 例（23.7%）为中危（CURB-65=2），42 例（15.1%）为 30 天死亡率高危（CURB-65 35）。研究期间，88 例（31.5%）患者出现不良结局。CURB-65 与不良结局显著相关（P<0.001）。然而，在 CURB-65 为 01 的患者中，即被认为低危的患者中，有 36/171（21.1%）例出现不良结局。
我们的研究表明，CURB-65 用于指导住院或门诊治疗决策的适用性较差，因为它不能安全地识别可门诊管理的患者。
