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Predictability of Severity Scores in Patients over 70 Years Old with COVID-19 Infection: Results from a Single-Center
Andreea Magdalena Ghibu1,2, Ionela Maniu3,4, Victoria Birlutiu1,2
1Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania.
Insights
The PADUA, MuLBSTA, and Pneumonia Severity Index (PSI) scores accurately predict COVID-19 mortality in elderly patients. These scores are vital for managing SARS-CoV-2 infection in older adults.
Area of Science:
- Gerontology
- Infectious Diseases
- Medical Informatics
Background:
- Elderly individuals are at high risk for severe SARS-CoV-2 infection and COVID-19 mortality.
- Comorbidities significantly increase mortality risk in elderly COVID-19 patients.
- Severity scoring systems are crucial for predicting mortality and guiding medical practice.
Purpose of the Study:
- To evaluate the predictive accuracy of five COVID-19 severity scores in patients over 70.
- To compare the performance of CURB-65, Pneumonia Severity Index (PSI), MuLBSTA, COVID-GRAM, and PADUA scores.
Main Methods:
- Retrospective study of 173 patients aged over 70 with SARS-CoV-2 infection.
- Analysis of demographic data, vaccination status, comorbidities, and discharge outcomes.
- Calculation and comparison of five distinct severity scores (CURB-65, PSI, MuLBSTA, COVID-GRAM, PADUA).
Main Results:
- The PADUA score demonstrated the highest predictive accuracy (AUC=0.914), followed by MuLBSTA (AUC=0.854) and PSI (AUC=0.831).
- All tested severity scores were significantly higher in non-survivors.
- Comorbidities like hypertension, neurological conditions, diabetes, and obesity were prevalent; tumor pathology increased mortality risk.
Conclusions:
- The PADUA, MuLBSTA, and PSI scores show acceptable predictive ability for mortality in elderly COVID-19 patients.
- These validated scores can aid in clinical decision-making and resource allocation for high-risk elderly populations.
Abstract:
Background: The elderly remain a population group at risk of developing severe forms of SARS-CoV-2 infection. Age and the prevalence of comorbidities are important risk factors for mortality related to COVID-19. Severity scores enhance medical practice, proving to be useful tools in predicting mortality. Objectives: The purpose of this study is to assess the predictive accuracy of the CURB-65, Pneumonia Severity Index, MuLBSTA, COVID-GRAM and PADUA scores in patients over 70 years of age diagnosed with SARS-CoV-2 infection. Methods: We performed a retrospective study between June 2023 and December 2024, analyzing demographic data, vaccination status, comorbidities, discharge status, and computed the five scores. Results: A total of 173 patients aged over 70 years old were included in the study. Among them, 56.06% were male with a median age of 79.72 ± 6.55. Many patients had at least one comorbidity (93.06), among which hypertension (67.63%), neurological pathology (41.61%), diabetes mellitus (28.90%) and obesity (28.32%). Tumor pathology was associated with an increased risk of death. Admission to the intensive care unit and mechanical ventilation were also risk factors for increased mortality in the study population. The area under the ROC curve (AUC) of the scores (in descending order) was: 0.914 for PADUA, 0.854 for MuLBSTA, 0.831 for PSI, 0.719 for CURB-65 and 0.703 for COVID-GRAM. Conclusions: All the severity scores used were significantly higher in the non-survivor group, with PSI, MuLBSTA, and PADUA scores revealing acceptable prediction ability for mortality.
