First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Japan.
Department of Emergency Medicine, Kansai Medical University Medical Center, Japan.
J Infect Chemother. 2024 May;30(5):463-466. doi: 10.1016/j.jiac.2023.11.007. Epub 2023 Nov 10.
We demonstrated that there was a significant relationship between the severity measured using the A-DROP scoring system and the mortality rate in patients with COVID-19 community-acquired pneumonia (CAP) in the ancestral strain, Alpha variant, and Delta variant. We investigated the usefulness of the A-DROP scoring system in SARS-CoV-2 Omicron variant CAP and compared it with severity scores, the Pneumonia Severity Index (PSI) and CURB-65 score.
We analyzed a total of 547 patients with COVID-19 CAP Omicron variant; 198 cases were the BA.1 subvariant, 127 cases were the BA.2 subvariant, and 222 cases were the BA.5 subvariant, respectively.
The mortality rates in patients with COVID-19 CAP among the three Omicron subvariants were identical in each pneumonia severity group. The mortality rate in patients with the Omicron variant was 0 % in patients classified with mild disease, 0.6 % in those with moderate disease, 10.4 % in those with severe disease, and 34.8 % in those with extremely severe disease. The mortality rate in patients with COVID-19 CAP increased depending on the severity classified according to the A-DROP system in each of the Omicron subvariants (Cochran-Armitage trend test; p < 0.001). The values of the area under the curve in Receiver Operating Characteristic analysis for prediction of 30-day mortality was 0.881, 0.879, and 0.863 for A-DROP, PSI, and CURB-65, respectively. There were no significant differences in the predictive ability of each pneumonia severity score.
Our results demonstrated that the A-DROP scoring system is useful for predicting mortality in patients with COVID-19 CAP.
我们证明，在新冠病毒原始株、阿尔法变异株和德尔塔变异株中，使用 A-DROP 评分系统评估的严重程度与 COVID-19 社区获得性肺炎（CAP）患者的死亡率之间存在显著关系。我们研究了 A-DROP 评分系统在 SARS-CoV-2 奥密克戎变异株 CAP 中的有效性，并将其与严重程度评分、肺炎严重指数（PSI）和 CURB-65 评分进行了比较。
我们共分析了 547 例新冠病毒奥密克戎变异株 CAP 患者；其中 198 例为 BA.1 亚变异株，127 例为 BA.2 亚变异株，222 例为 BA.5 亚变异株。
在三种奥密克戎亚变异株中，不同肺炎严重程度组的 COVID-19 CAP 患者死亡率相同。奥密克戎变异株患者的死亡率在轻症患者中为 0%，在中度患者中为 0.6%，在重症患者中为 10.4%，在极重症患者中为 34.8%。在三种奥密克戎亚变异株中，根据 A-DROP 系统分类的严重程度，COVID-19 CAP 患者的死亡率随之增加（Cochran-Armitage 趋势检验；p<0.001）。在预测 30 天死亡率方面，A-DROP、PSI 和 CURB-65 的受试者工作特征曲线下面积值分别为 0.881、0.879 和 0.863。各肺炎严重程度评分的预测能力无显著差异。
我们的结果表明，A-DROP 评分系统可用于预测 COVID-19 CAP 患者的死亡率。
