Performance of CURB-65 and ISARIC 4C mortality scores for hospitalized patients with confirmed COVID-19 infection in Saudi Arabia

BACKGROUND: The COVID-19 pandemic continues with new waves that could persist with the arrival of new SARS-CoV-2 variants. Therefore, the availability of validated and effective triage tools is the cornerstone for proper clinical management. Thus, this study aimed to assess the validity of the ISARI...

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Detalles Bibliográficos
Autores principales: Alwazzeh, Marwan Jabr, Subbarayalu, Arun Vijay, Abu Ali, Batool Mohammed, alabdulqader, Reema, Alhajri, Mashael, Alwarthan, Sara M., AlShehail, Bashayer M., Raman, Vinoth, Almuhanna, Fahd Abdulaziz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Authors. Published by Elsevier Ltd. 2023
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167802/
https://www.ncbi.nlm.nih.gov/pubmed/37193544
http://dx.doi.org/10.1016/j.imu.2023.101269
Descripción
Sumario:BACKGROUND: The COVID-19 pandemic continues with new waves that could persist with the arrival of new SARS-CoV-2 variants. Therefore, the availability of validated and effective triage tools is the cornerstone for proper clinical management. Thus, this study aimed to assess the validity of the ISARIC-4C score as a triage tool for hospitalized COVID-19 patients in Saudi Arabia and to compare its performance with the CURB-65 score. MATERIAL AND METHODS: This retrospective observational cohort study was conducted between March 2020 and May 2021 at KFHU, Saudi Arabia, using 542 confirmed COVID-19 patient data on the variables relevant to the application of the ISARIC-4C mortality score and the CURB-65 score. Chi-square and t-tests were employed to study the significance of the CURB-65 score and the ISARIC-4C score variables considering the ICU requirements and the mortality of COVID-19 hospitalized patients. In addition, logistic regression was used to predict the variables related to COVID-19 mortality. In addition, the diagnostic accuracy of both scores was validated by calculating sensitivities, specificities, positive predictive value, negative predictive value, and Youden's J indices (YJI). RESULTS: ROC analysis showed an AUC value of 0.834 [95% CI; 0.800–0.865]) for the CURB-65 score and 0.809 [95% CI; 0.773–0.841]) for the ISARIC-4C score. The sensitivity for CURB-65 and ISARIC-4C is 75% and 85.71%, respectively, while the specificity was 82.31% and 62.66%, respectively. The difference between AUCs was 0.025 (95% [CI; −0.0203-0.0704], p = 0.2795). CONCLUSION: Study results support external validation of the ISARIC-4C score in predicting the mortality risk of hospitalized COVID-19 patients in Saudi Arabia. In addition, the CURB-65 and ISARIC-4C scores showed comparable performance with good consistent discrimination and are suitable for clinical utility as triage tools for hospitalized COVID-19 patients.

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