CURB-65, qSOFA, and SIRS Criteria in Predicting In-Hospital Mortality of Critically Ill COVID-19 Patients; a Prognostic Accuracy Study

ntroduction:Outcome prediction of intensive care unit (ICU)-admitted patients is one of the important is-sues for physicians. This study aimed to compare the accuracy of Quick Sequential Organ Failure Assessment(qSOFA), Confusion, Urea, Respiratory Rate, Blood Pressure and Age Above or Below 65 Years (CURB-65), andSystemic Inflammatory Response Syndrome (SIRS) scores in predicting the in-hospital mortality of COVID-19patients.

This prognostic accuracy study was performed on 225 ICU-admitted patients with a defini-tive diagnosis of COVID-19 from July to December 2021 in Tehran, Iran. The patients’ clinical characteristicswere evaluated at the time of ICU admission, and they were followed up until discharge from ICU. The screeningperformance characteristics of CURB-65, qSOFA, and SIRS in predicting their mortality was compared.

225 patients with the mean age of 63.27±14.89 years were studied (56.89% male). The in-hospital mortality rateof this series of patients was 39.10%. The area under the curve (AUC) of SIRS, CURB-65, and qSOFA were 0.62(95% CI: 0.55 - 0.69), 0.66 (95% CI: 0.59 - 0.73), and 0.61(95% CI: 0.54 - 0.67), respectively (p = 0.508). In cut-off≥1, the estimated sensitivity values of SIRS, CURB-65, and qSOFA were 85.23%, 96.59%, and 78.41%, respectively.The estimated specificity of scores were 34.31%, 6.57%, and 38.69%, respectively. In cut-off≥2, the sensitivityvalues of SIRS, CURB-65, and qSOFA were evaluated as 39.77%, 87.50%, and 15.91%, respectively. Meanwhile,the specificity of scores were 72.99%, 34.31%, and 92.70%.

It seems that the performance of SIRS,CURB-65, and qSOFA is similar in predicting the ICU mortality of COVID-19 patients. However, the sensitivityof CURB-65 is higher than qSOFA and SIRS.