Comparative evaluation of baseline SOFA score and CURB-65 score in predicting patient severity and outcome in COVID-19 patients admitted to a tertiary care ICU

Abstract

COVID-19 is primarily a pulmonary disease, but with significant and frequent systemic manifestations. Our study aims to assess, which scoring system on admission—Confusion, Uraemia, Respiratory Rate > 30/min, Blood Pressure low, Age > 65 years (CURB-65) or SOFA, better correlates with COVID-19-positive patient mortality. This prospective observational study was conducted in COVID-positive adult patients. Upon admission, patient demographics, clinical condition and laboratory investigations were noted. SOFA and CURB-65 scores were calculated for each patient and the patient was followed up till the final outcome—transfer or expiry. Out of the 100 patients included in our study, the majority belonged to the age group of 41–60 years, with a mean age of 51 years. A significant proportion of patients (83%) had at least 1 pre-existing co-morbidity. The absence of co-morbidity showed an association with improved survival. The overall mortality rate was 46%. Baseline SOFA and CURB-65 scores showed a correlation with patient outcome, but SOFA showed a greater strength of association. It was found that at a cut-off of a total SOFA score of ≥4, it predicts patient expiry with a sensitivity of 89% and a specificity of 72%. CURB-65 is a scoring system used for severity assessment, guide therapy and prognostication of patients with lower respiratory tract infection or pneumonia. SOFA, on the other hand, is an ICU score used in multi-system diseases used for evaluating disease progression and prognostication. Many authors have found that SOFA score correlates well with patient outcome, and a high SOFA on admission usually indicates poor prognosis.