Service of Infectious Diseases, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain.
Service of Respiratory Medicine, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Int J Infect Dis. 2021 Jul;108:282-288. doi: 10.1016/j.ijid.2021.05.048. Epub 2021 May 24.
The aim of this study was to determine the usefulness of COVID-GRAM and CURB-65 scores as predictors of the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Caucasian patients.
This was a retrospective observational study including all adults with SARS-CoV-2 infection admitted to Hospital Universitario Marqués de Valdecilla from February to May 2020. Patients were stratified according to COVID-GRAM and CURB-65 scores as being at low-medium or high risk of critical illness. Univariate analysis, multivariate logistic regression models, receiver operating characteristic curve, and area under the curve (AUC) were calculated.
A total of 523 patients were included (51.8% male, 48.2% female; mean age 65.63 years (standard deviation 17.89 years)), of whom 110 (21%) presented a critical illness (intensive care unit admission 10.3%, 30-day mortality 13.8%). According to the COVID-GRAM score, 122 (23.33%) patients were classified as high risk; 197 (37.7%) presented a CURB-65 score ≥2. A significantly greater proportion of patients with critical illness had a high COVID-GRAM score (64.5% vs 30.5%; P < 0.001). The COVID-GRAM score emerged as an independent predictor of critical illness (odds ratio 9.40, 95% confidence interval 5.51-16.04; P < 0.001), with an AUC of 0.779. A high COVID-GRAM score showed an AUC of 0.88 for the prediction of 30-day mortality, while a CURB-65 ≥2 showed an AUC of 0.83.
The COVID-GRAM score may be a useful tool for evaluating the risk of critical illness in Caucasian patients with SARS-CoV-2 infection. The CURB-65 score could be considered as an alternative.
本研究旨在确定 COVID-GRAM 和 CURB-65 评分作为预测白人严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染严重程度的指标的有用性。
这是一项回顾性观察性研究，纳入了 2020 年 2 月至 5 月期间因 SARS-CoV-2 感染入住 Hospital Universitario Marqués de Valdecilla 的所有成年患者。根据 COVID-GRAM 和 CURB-65 评分，将患者分为低-中危或高危重症的亚组。进行了单因素分析、多因素逻辑回归模型、受试者工作特征曲线和曲线下面积（AUC）的计算。
共纳入 523 例患者（51.8%为男性，48.2%为女性；平均年龄 65.63 岁（标准差 17.89 岁）），其中 110 例（21%）出现重症（入住重症监护病房 10.3%，30 天死亡率 13.8%）。根据 COVID-GRAM 评分，122 例（23.33%）患者被归类为高危；197 例（37.7%）患者的 CURB-65 评分≥2。重症患者中 COVID-GRAM 评分高的比例明显更高（64.5% vs 30.5%；P < 0.001）。COVID-GRAM 评分是重症的独立预测因子（优势比 9.40，95%置信区间 5.51-16.04；P < 0.001），AUC 为 0.779。高 COVID-GRAM 评分预测 30 天死亡率的 AUC 为 0.88，而 CURB-65≥2 的 AUC 为 0.83。
COVID-GRAM 评分可用于评估白人 SARS-CoV-2 感染患者发生重症的风险，是一种有用的工具。CURB-65 评分可作为替代指标。
