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Observational Study
. 2021 Jul:108:282-288.
doi: 10.1016/j.ijid.2021.05.048. Epub 2021 May 24.

Usefulness of the COVID-GRAM and CURB-65 scores for predicting severity in patients with COVID-19

Carlos Armiñanzas  1 , Francisco Arnaiz de Las Revillas  2 , Manuel Gutiérrez Cuadra  3 , Ana Arnaiz  4 , Marta Fernández Sampedro  5 , Claudia González-Rico  6 , Diego Ferrer  7 , Víctor Mora  8 , Borja Suberviola  9 , Maite Latorre  10 , Jorge Calvo  11 , José Manuel Olmos  12 , José Manuel Cifrián  13 , María Carmen Fariñas  14
Affiliations
Observational Study

Usefulness of the COVID-GRAM and CURB-65 scores for predicting severity in patients with COVID-19

Carlos Armiñanzas et al. Int J Infect Dis. 2021 Jul.

Abstract

Aim: The aim of this study was to determine the usefulness of COVID-GRAM and CURB-65 scores as predictors of the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Caucasian patients.

Methods: This was a retrospective observational study including all adults with SARS-CoV-2 infection admitted to Hospital Universitario Marqués de Valdecilla from February to May 2020. Patients were stratified according to COVID-GRAM and CURB-65 scores as being at low-medium or high risk of critical illness. Univariate analysis, multivariate logistic regression models, receiver operating characteristic curve, and area under the curve (AUC) were calculated.

Results: A total of 523 patients were included (51.8% male, 48.2% female; mean age 65.63 years (standard deviation 17.89 years)), of whom 110 (21%) presented a critical illness (intensive care unit admission 10.3%, 30-day mortality 13.8%). According to the COVID-GRAM score, 122 (23.33%) patients were classified as high risk; 197 (37.7%) presented a CURB-65 score ≥2. A significantly greater proportion of patients with critical illness had a high COVID-GRAM score (64.5% vs 30.5%; P < 0.001). The COVID-GRAM score emerged as an independent predictor of critical illness (odds ratio 9.40, 95% confidence interval 5.51-16.04; P < 0.001), with an AUC of 0.779. A high COVID-GRAM score showed an AUC of 0.88 for the prediction of 30-day mortality, while a CURB-65 ≥2 showed an AUC of 0.83.

Conclusions: The COVID-GRAM score may be a useful tool for evaluating the risk of critical illness in Caucasian patients with SARS-CoV-2 infection. The CURB-65 score could be considered as an alternative.

Keywords: COVID; COVID-GRAM; CURB-65; Coronavirus; Severity score.

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Figures

Figure 1
Figure 1
ROC curves to assess the accuracy of the COVID-GRAM score and CURB-65 score at admission for predicting critical illness and 30-day mortality in 523 patients hospitalized with COVID-19. (A) Accuracy of the COVID-GRAM score for predicting critical illness; (B) accuracy of the CURB-65 score for predicting critical illness; (C) accuracy of the COVID-GRAM score for predicting 30-day mortality; and (D) accuracy of the CURB-65 score for predicting 30-day mortality.
Figure 2
Figure 2
Kaplan–Meier curve for overall survival among 523 patients hospitalized with COVID-19 stratified by (A) COVID GRAM score and (B) CURB-65 score.
See this image and copyright information in PMC

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