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Updated: Dec 18, 2025
Experimental Model to Evaluate Resolution of Pneumonia
Published on: February 17, 2023
Performance of pneumonia severity index and CURB-65 in predicting 30-day mortality in patients with COVID-19
Celal Satici1, Mustafa Asim Demirkol1, Elif Sargin Altunok2
1Department of Chest Diseases, Gaziosmanpasa Research and Training Hospital, University of Health Sciences, Istanbul, 34255, Turkey.
Objective:
The aim of the study was to analyze the usefulness of CURB-65 and the pneumonia severity index (PSI) in predicting 30-day mortality in patients with COVID-19, and to identify other factors associated with higher mortality.
Methods:
A retrospective study was performed in a pandemic hospital in Istanbul, Turkey, which included 681 laboratory-confirmed patients with COVID-19. Data on characteristics, vital signs, and laboratory parameters were recorded from electronic medical records. Receiver operating characteristic analysis was used to quantify the discriminatory abilities of the prognostic scales. Univariate and multivariate logistic regression analyses were performed to identify other predictors of mortality.
Results:
Higher CRP levels were associated with an increased risk for mortality (OR: 1.015, 95% CI: 1.008-1.021; p < 0.001). The PSI performed significantly better than CURB-65 (AUC: 0.91, 95% CI: 0.88-0.93 vs AUC: 0.88, 95% CI: 0.85-0.90; p = 0.01), and the addition of CRP levels to PSI did not improve the performance of PSI in predicting mortality (AUC: 0.91, 95% CI: 0.88-0.93 vs AUC: 0.92, 95% CI: 0.89-0.94; p = 0.29).
Conclusion:
In a large group of hospitalized patients with COVID-19, we found that PSI performed better than CURB-65 in predicting mortality. Adding CRP levels to PSI did not improve the 30-day mortality prediction.
Insights
The Pneumonia Severity Index (PSI) better predicts 30-day mortality in COVID-19 patients than CURB-65. C-reactive protein (CRP) levels did not enhance PSI
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Pulmonology
Background:
- COVID-19 poses a significant mortality risk.
- Accurate prediction of mortality is crucial for patient management.
- Existing prognostic scores require evaluation for COVID-19.
Purpose of the Study:
- To assess the utility of CURB-65 and PSI in predicting 30-day mortality in COVID-19 patients.
- To identify additional mortality predictors in COVID-19.
Main Methods:
- Retrospective analysis of 681 laboratory-confirmed COVID-19 patients.
- Evaluation of CURB-65 and PSI using receiver operating characteristic (ROC) analysis.
- Logistic regression to identify mortality predictors.
Main Results:
- PSI demonstrated superior discrimination compared to CURB-65 (AUC 0.91 vs 0.88).
- Higher C-reactive protein (CRP) levels correlated with increased mortality risk (OR 1.015).
- Adding CRP to PSI did not significantly improve mortality prediction (AUC 0.91 vs 0.92).
Conclusions:
- PSI is a more effective tool than CURB-65 for predicting 30-day mortality in hospitalized COVID-19 patients.
- CRP levels, while associated with mortality risk, do not enhance the predictive performance of PSI.
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