Portuguese Society of Intensive Care Score for Predicting SARS-CoV-2 Infection Applied to Inpatients with Pneumonia: A Reliable Tool?
2021
Objectives: Early identification of patients with the novel coronavirus induced-disease 2019 (COVID-19) and pneumonia is
currently challenging. Few data are available on validated scores
predictive of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)
infection. The Portuguese Society of Intensive Care (PSIC) proposed a risk
score whose main goals were to predict a higher probability of COVID-19 and
optimize hospital resources, adjusting patients’ intervention. This study aimed
to validate the PSIC risk score applied to inpatients with pneumonia. Methods: A retrospective analysis of 207 patients with pneumonia admitted to a
suspected/confirmed SARS-CoV-2 infection
specialized ward (20/03 to 20/05/2020) was performed. Score variables
were analyzed to determine the significance of the independent predictive variables on the probability of a
positive SARS-CoV-2 rRT-PCR test. The binary logistic regression
modeling approach was selected. The best cut-off value was obtained with the
Receiver Operating Characteristic (ROC) curve together with the evaluation of
the discriminatory power through the Area Under the Curve (AUC). Results: The
validation cohort included 145 patients. Typical chest
computed-tomography features (OR, 12.16; 95% CI, 3.32 - 44.50)
and contact with a positive SARS-CoV-2 patient (OR, 6.56; 95% CI, 1.33 - 32.30)
were the most significant independent predictive variables. A score ≥ 10
increased suspicion for SARS-CoV-2 pneumonia. The AUC was 0.82 (95% CI, 0.73 - 0.91) demonstrating the good discriminating power for
COVID-19 probability stratification in inpatients with pneumonia. Conclusions: The application of the PSIC score to inpatients with pneumonia may be of
value in predicting the risk of COVID-19. Further
studies from other centers are needed to validate this score widely.
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