A retrospective study has found that hospitalized patients with Covid-19 had higher mortality, if their CURB-65 score was 2 or more.

Researchers in Ecuador examined the utility of CURB-65 in predicting 30-day mortality in 247 adult patients hospitalized with COVID-19. Their mean age was 60 years. The study was conducted between March and April in 2020. CURB-65 was calculated for all patients during their first contact in the Emergency Department.

Most patients complained of dyspnoea (90.7%) followed by fever (85.4%), cough (84.2%), and weakness (81%). Seventy-six percent of patients had bilateral pneumonia and 35.2% patients showed interstitial involvement on chest CT scan.

Based on the CURB score, patients were categorized into two: 0–1 and ≥2.

Patients with CURB-65 of ≥ 2 were more likely to be older (64 vs 54 years) and have comorbid conditions like hypertension (57 vs 36.2%), overweight/obesity (34 vs 20.2%) and coronary artery disease (7.3 vs 0%). They also had higher probability of having lower SpO2 (81 vs 88), more ARDS (68.9 vs 49.8%) and requiring mechanical ventilation (55 vs 36.2%). Mortality rate at 30 days was higher in patients with CURB-65 of ≥ 2 compared to those who scored less than one; 57 versus 17%, respectively.

The CURB-65 score is very commonly used to assess mortality in patients with community-acquired pneumonia. It includes five variables: confusion, urea > 42 mg/dL, respiratory rate > 30 rpm, blood pressure < 90 mmHg (systolic) and < 60 mmHg (diastolic) and age 65 years or older.

This study reported in the journal Revista Clínica Española has demonstrated the usefulness of CURB-65 score as a simple and easy means to predict mortality in hospitalized patients with Covid-19. Significant differences were observed between the two groups. It can be quickly used to triage high risk patients for timely interventions.

Reference

1. Carriel J, et al. CURB-65 as a predictor of 30-day mortality in patients hospitalized with COVID-19 in Ecuador: COVID-EC study. Rev Clin Esp (Barc). 2022 Jan;222(1):37-41.  doi: 10.1016/j.rceng.2020.10.006. Epub 2021 Apr 30.