Division of Pulmonary Medicine, Department of Internal Medicine, Self-Defense Forces Central Hospital, 1-2-24 Ikejiri, Setagaya, Tokyo, 154-8532, Japan.
Department of Anesthesiology, Self-Defense Forces Central Hospital, 1-2-24 Ikejiri, Setagaya, Tokyo, 154-8532, Japan.
J Infect Chemother. 2021 Feb;27(2):336-341. doi: 10.1016/j.jiac.2020.12.009. Epub 2020 Dec 16.
In patients with severe coronavirus disease 2019 (COVID-19), respiratory failure is a major complication and its symptoms occur around one week after onset. The CURB-65, A-DROP and expanded CURB-65 tools are known to predict the risk of mortality in patients with community-acquired pneumonia. In this retrospective single-center retrospective study, we aimed to assess the correlations of the A-DROP, CURB-65, and expanded CURB-65 scores on admission with an increase in oxygen requirement in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia.
We retrospectively analyzed 207 patients who were hospitalized with SARS-CoV-2 pneumonia at the Self-Defense Forces Central Hospital in Tokyo, Japan. Performance of A-DROP, CURB-65, and the expanded CURB-65 scores were validated. In addition, we assessed whether there were any associations between an increase in oxygen requirement and known risk factors for critical illness in COVID-19, including elevation of liver enzymes and C-reactive protein (CRP), lymphocytopenia, high D-dimer levels and the chest computed tomography (CT) score.
The areas under the curve for the ability of CURB-65, A-DROP, and the expanded CURB-65 scores to predict an increase in oxygen requirement were 0.6961, 0.6980 and 0.8327, respectively, and the differences between the three groups were statistically significant (p < 0.001). Comorbid cardiovascular disease, lymphocytopenia, elevated CRP, liver enzyme and D-dimer levels, and higher chest CT score were significantly associated with an increase in oxygen requirement CONCLUSIONS: The expanded CURB-65 score can be a better predictor of an increase in oxygen requirement in patients with SARS-CoV-2 pneumonia.
在患有严重 2019 年冠状病毒病（COVID-19）的患者中，呼吸衰竭是一种主要并发症，其症状通常在发病后一周左右出现。CURB-65、A-DROP 和扩展 CURB-65 工具常用于预测社区获得性肺炎患者的死亡风险。在这项回顾性单中心回顾性研究中，我们旨在评估入院时 A-DROP、CURB-65 和扩展 CURB-65 评分与严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）肺炎患者氧需求增加的相关性。
我们回顾性分析了在日本东京自卫队中央医院因 SARS-CoV-2 肺炎住院的 207 例患者。验证了 A-DROP、CURB-65 和扩展 CURB-65 评分的性能。此外，我们评估了氧需求增加与 COVID-19 中危重症的已知危险因素（包括肝酶和 C 反应蛋白（CRP）升高、淋巴细胞减少、高 D-二聚体水平和胸部计算机断层扫描（CT）评分）之间是否存在任何关联。
CURB-65、A-DROP 和扩展 CURB-65 评分预测氧需求增加的曲线下面积分别为 0.6961、0.6980 和 0.8327，三组之间差异有统计学意义（p<0.001）。合并心血管疾病、淋巴细胞减少、CRP、肝酶和 D-二聚体水平升高以及胸部 CT 评分较高与氧需求增加显著相关。
扩展 CURB-65 评分可以更好地预测 SARS-CoV-2 肺炎患者氧需求的增加。
