The Clinical Use of the Pneumonia Severity Index and the COVID-GRAM Score in Patients Diagnosed with COVID-19
Introduction: Confirmed prognostic scales, such as the Pneumonia Severity Index (PSI), are commonly employed to guide treatment for patients with pneumonia. COVID-19 pneumonia-specific scores like COVID GRAM have been developed for assessing mortality risk and the requirement for intensive care,. In...
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| Format: | Article |
| Language: | English |
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Bilimsel Tip Yayinevi
2023-09-01
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| Series: | Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi |
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| Online Access: | http://www.floradergisi.org/managete/fu_folder/2023-03/2023-28-03-353-364.pdf |
| _version_ | 1797676982652108800 |
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| author | Gülnur Kul |
| author_facet | Gülnur Kul |
| author_sort | Gülnur Kul |
| collection | DOAJ |
| description | Introduction: Confirmed prognostic scales, such as the Pneumonia Severity Index (PSI), are commonly employed to guide treatment for patients with pneumonia. COVID-19 pneumonia-specific scores like COVID GRAM have been developed for assessing mortality risk and the requirement for intensive care,. In this study, our objective was to examine the predictive value of both non-specific and disease-specific scoring systems in assessing clinical severity and 28-day mortality in patients with COVID-19.
Materials and Methods: Patients with positive COVID-19 PCR tests were included in the study. The parameters of the COVID-GRAM score include age, imaging findings, number of comorbidities, clinical findings such as dyspnea and altered consciousness, as well as lactate dehydrogenase and direct bilirubin levels. The patients were evaluated according to both the results of the scoring systems and their clinical status of severe pneumonia and mild-moderate pneumonia. Demographic characteristics, comorbidities, baseline laboratory parameters, and time to death were obtained from electronic medical records.
Results: A total of 188 patients, 107 of whom were male, were included in our study. The 28-day mortality rate was 21.2%. Mortality increased with prolonged hospital stay (p= 0.009). Upon evaluating the scoring systems, it was observed that both the PSI score and COVID-GRAM values were significantly higher in individuals who had a fatal outcome (p= 0.001 and p= 0.019, respectively). A noticeable increase in mortality rates was observed across risk groups (from group I to V) among patients categorized based on PSI scoring. We performed a ROC curve analysis to calculate the cutoff values of these scoring systems in estimating 28-day mortality. In the PSI scoring system, the sensitivity was 95%, and the specificity was 18.9%. In the COVID-GRAM score, the sensitivity was 92.5%, and the specificity was 17.6%. Both scores were statistically significant in predicting 28-day mortality (p< 0.001).
Conclusion: Comparative data on scoring systems will provide valuable insights into the scientific literature, aiding in the appropriate allocation of resources and facilitating decisions regarding close patient monitoring during the peak phases of the pandemic. As our understanding of COVID-19 continues to expand, the incorporation of additional variables into the COVID-GRAM score holds the potential to enhance its utility and effectiveness. |
| first_indexed | 2024-03-11T22:38:20Z |
| format | Article |
| id | doaj.art-d9fbbce0ae2c4b49ac0efb43d7eee2c9 |
| institution | Directory Open Access Journal |
| issn | 1300-932X |
| language | English |
| last_indexed | 2024-03-11T22:38:20Z |
| publishDate | 2023-09-01 |
| publisher | Bilimsel Tip Yayinevi |
| record_format | Article |
| series | Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi |
| spelling | doaj.art-d9fbbce0ae2c4b49ac0efb43d7eee2c92023-09-22T11:14:28ZengBilimsel Tip YayineviFlora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi1300-932X2023-09-0128335336410.5578/flora.20239705The Clinical Use of the Pneumonia Severity Index and the COVID-GRAM Score in Patients Diagnosed with COVID-19Gülnur Kul0https://orcid.org/0000-0001-7317-3461Clinic of Infectous Diseases and Clinic Microbiology, Kırıkhan Public Hospital, Hatay, TürkiyeIntroduction: Confirmed prognostic scales, such as the Pneumonia Severity Index (PSI), are commonly employed to guide treatment for patients with pneumonia. COVID-19 pneumonia-specific scores like COVID GRAM have been developed for assessing mortality risk and the requirement for intensive care,. In this study, our objective was to examine the predictive value of both non-specific and disease-specific scoring systems in assessing clinical severity and 28-day mortality in patients with COVID-19. Materials and Methods: Patients with positive COVID-19 PCR tests were included in the study. The parameters of the COVID-GRAM score include age, imaging findings, number of comorbidities, clinical findings such as dyspnea and altered consciousness, as well as lactate dehydrogenase and direct bilirubin levels. The patients were evaluated according to both the results of the scoring systems and their clinical status of severe pneumonia and mild-moderate pneumonia. Demographic characteristics, comorbidities, baseline laboratory parameters, and time to death were obtained from electronic medical records. Results: A total of 188 patients, 107 of whom were male, were included in our study. The 28-day mortality rate was 21.2%. Mortality increased with prolonged hospital stay (p= 0.009). Upon evaluating the scoring systems, it was observed that both the PSI score and COVID-GRAM values were significantly higher in individuals who had a fatal outcome (p= 0.001 and p= 0.019, respectively). A noticeable increase in mortality rates was observed across risk groups (from group I to V) among patients categorized based on PSI scoring. We performed a ROC curve analysis to calculate the cutoff values of these scoring systems in estimating 28-day mortality. In the PSI scoring system, the sensitivity was 95%, and the specificity was 18.9%. In the COVID-GRAM score, the sensitivity was 92.5%, and the specificity was 17.6%. Both scores were statistically significant in predicting 28-day mortality (p< 0.001). Conclusion: Comparative data on scoring systems will provide valuable insights into the scientific literature, aiding in the appropriate allocation of resources and facilitating decisions regarding close patient monitoring during the peak phases of the pandemic. As our understanding of COVID-19 continues to expand, the incorporation of additional variables into the COVID-GRAM score holds the potential to enhance its utility and effectiveness. http://www.floradergisi.org/managete/fu_folder/2023-03/2023-28-03-353-364.pdfcovid-19covid-grammortalitypneumonia severity index |
| spellingShingle | Gülnur Kul The Clinical Use of the Pneumonia Severity Index and the COVID-GRAM Score in Patients Diagnosed with COVID-19 Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi covid-19 covid-gram mortality pneumonia severity index |
| title | The Clinical Use of the Pneumonia Severity Index and the COVID-GRAM Score in Patients Diagnosed with COVID-19 |
| title_full | The Clinical Use of the Pneumonia Severity Index and the COVID-GRAM Score in Patients Diagnosed with COVID-19 |
| title_fullStr | The Clinical Use of the Pneumonia Severity Index and the COVID-GRAM Score in Patients Diagnosed with COVID-19 |
| title_full_unstemmed | The Clinical Use of the Pneumonia Severity Index and the COVID-GRAM Score in Patients Diagnosed with COVID-19 |
| title_short | The Clinical Use of the Pneumonia Severity Index and the COVID-GRAM Score in Patients Diagnosed with COVID-19 |
| title_sort | clinical use of the pneumonia severity index and the covid gram score in patients diagnosed with covid 19 |
| topic | covid-19 covid-gram mortality pneumonia severity index |
| url | http://www.floradergisi.org/managete/fu_folder/2023-03/2023-28-03-353-364.pdf |
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