• Atención primaria
• Enfermedades transmisibles
• Infectious diseases
• Neumonía
• Pneumonia
• Primary health care

• Artificial intelligence
• Mortality
• Pneumonia
• Prognosis
• Radiography

• Prognosis
• Pneumonia/diagnosis
• Pneumonia/diagnostic imaging
• Artificial Intelligence
• Radiography, Thoracic
• Humans
• Male
• Female
• Aged
• Aged, 80 and over
• Respiratory Rate
• Blood Pressure
• Confusion
• Urea/blood
• Severity of Illness Index
• Models, Statistical

• DK-IIT-2021-04 DongKook Life Science
• 2022-32-0055 Yonsei University College of Medicine

• Mortality
• Nursing home-acquired pneumonia
• Nursing- and healthcare-associated pneumonia
• Prognosis
• Severity score

• Humans
• Healthcare-Associated Pneumonia/mortality
• Healthcare-Associated Pneumonia/diagnosis
• Severity of Illness Index
• Prognosis
• Area Under Curve

• COVID 19
• Hair hormone
• Mortality
• Progesterone
• Prognosis
• Severe pneumonia

This article aims to assess the utility of CURB-65 in predicting 30-day mortality in adult patients hospitalized with COVID-19.

This work is a cohort study conducted between March 1 and April 30, 2020 in Ecuador.

A total of 247 patients were included (mean age 60 ± 14 years, 70% men, overall mortality 41.3%). Patients with CURB-65 ≥ 2 had a higher mortality rate (57 vs. 17%, p < .001) that was associated with other markers of risk: advanced age, hypertension, overweight/obesity, kidney failure, hypoxemia, requirement for mechanical ventilation, or onset of respiratory distress.

CURB-65  ≥ 2 was associated with higher 30-day mortality on the univariate (Kaplan–Meier estimator) and multivariate (Cox regression) analysis.

• COVID-19
• CURB-65
• Coronavirus
• Mortalidad
• Mortality
• Neumonía
• Pneumonia
• SARS-CoV-2

The incidence and mortality rate of community-acquired pneumonia (CAP) in elderly patients were higher than the younger population. Different scoring systems, including The quick Sequential Organ Function Assessment (qSOFA), Combination of Confusion, Urea, Respiratory Rate, Blood Pressure, and Age ≥65 (CURB-65), Modified Early Warning Score (MEWS) and National Early Warning Score (NEWS), were used widely for predicting mortality and ICU admission of patients with community-acquired pneumonia (CAP). This study aimed to identify the most suitable score system for better hospitalization.

We retrospectively analyzed elderly patients with CAP in Minhang Hospital, Fudan University from 1 January 2018 to 1 January 2020. We recorded information of the patients including age, gender, underlying disease, consciousness state, vital signs, physiological and laboratory variables and further calculated the qSOFA, CURB-65, MEWS, and NEWS scores. Receiver operating characteristic (ROC) curves were used to predict the mortality risk and ICU admission. Kaplan–Meier survival curves were used in survival rate.

In total, 1044 patients were selected for analysis and divided into two groups, namely survivor groups (902 cases) and non-survivor groups (142 cases). Depending on ICU admission enrolled patients were classified into ICU admission (n = 102) and non-ICU admission (n = 942) groups. Mortality expressed as AUC values were 0.844 (p < 0.001), 0.868 (p < 0.001), 0.927 (p < 0.001) and 0.892 (p < 0.001) for qSOFA, CURB 65, MEWS and NEWS, respectively. There were clear differences in MEWS vs CURB-65 (p < 0.0001), MEWS vs NEWS (p < 0.001), MEWS vs qSOFA (p < 0.0001). For ICU-admission, the AUC values of qSOFA, CURB-65, MEWS and NEWS scores were 0.866 (p < 0.001), 0.854 (p < 0.001), 0.922 (p < 0.001), 0.976 (p < 0.001), respectively. There were significant differences in NEWS vs CURB-65 (p < 0.0001), NEWS vs MEWS (p < 0.001), NEWS vs qSOFA (p < 0.0001).

We explored the outcome prediction values of CURB65, qSOFA, MEWS and NEWS for patients aged 65-years and older with community-acquired pneumonia. We found that MEWS showed superiority over the other severity scores in predicting hospital mortality, and NEWS showed superiority over the other scores in predicting ICU admission.

• MEWS
• NEWS
• community-acquired pneumonia
• prognosis

• Humans
• Male
• Female
• Risk Factors
• Aged
• Prospective Studies
• Bedridden Persons
• Middle Aged
• Aged, 80 and over
• Healthcare-Associated Pneumonia/mortality
• Healthcare-Associated Pneumonia/epidemiology
• Pneumonia, Ventilator-Associated/mortality
• Pneumonia, Ventilator-Associated/epidemiology
• Cross Infection/mortality
• Cross Infection/epidemiology
• Pneumonia/mortality
• Comorbidity

• the Special Scientific Research Fund of Public Welfare Profession of China

Liver injury is common and also can be fatal, particularly in severe or critical patients with coronavirus disease 2019 (COVID-19).

To conduct an in-depth investigation into the risk factors for liver injury and into the effective measures to prevent subsequent mortality risk.

A retrospective cohort study was performed on 440 consecutive patients with relatively severe COVID-19 between January 28 and March 9, 2020 at Tongji Hospital, Wuhan, China. Data on clinical features, laboratory parameters, medications, and prognosis were collected.

COVID-19-associated liver injury more frequently occurred in patients aged ≥ 65 years, female patients, or those with other comorbidities, decreased lymphocyte count, or elevated D-dimer or serum ferritin (P < 0.05). The disease severity of COVID-19 was an independent risk factor for liver injury (severe patients: Odds ratio [OR] = 2.86, 95% confidence interval [CI]: 1.78-4.59; critical patients: OR = 13.44, 95%CI: 7.21-25.97). The elevated levels of on-admission aspartate aminotransferase and total bilirubin indicated an increased mortality risk (P < 0.001). Using intravenous nutrition or antibiotics increased the risk of COVID-19-associated liver injury. Hepatoprotective drugs tended to be of assistance to treat the liver injury and improve the prognosis of patients with COVID-19-associated liver injury.

More intensive monitoring of aspartate aminotransferase or total bilirubin is recommended for COVID-19 patients, especially patients aged ≥ 65 years, female patients, or those with other comorbidities. Drug hepatotoxicity of antibiotics and intravenous nutrition should be alert for COVID-19 patients.

• COVID-19
• Liver injury
• Prognosis
• Risk factors
• Drugs
• Alanine aminotransferase

• Adult
• Aged
• Aged, 80 and over
• COVID-19/complications
• COVID-19/mortality
• COVID-19/physiopathology
• China/epidemiology
• Female
• Follow-Up Studies
• Humans
• Liver Diseases/diagnosis
• Liver Diseases/mortality
• Liver Diseases/physiopathology
• Liver Diseases/virology
• Male
• Middle Aged
• Prognosis
• Retrospective Studies
• Risk Factors
• Survival Analysis

• APACHE II score
• CURB-65 score
• Disease assessment
• MuLBSTA score
• Novel coronavirus pneumonia

• APACHE
• Adult
• Aged
• Aged, 80 and over
• COVID-19/diagnosis
• COVID-19/mortality
• COVID-19/therapy
• COVID-19/virology
• Female
• Humans
• Male
• Middle Aged
• Pneumonia/diagnosis
• Pneumonia/mortality
• Pneumonia/therapy
• Pneumonia/virology
• Prognosis
• ROC Curve
• Risk Assessment
• SARS-CoV-2
• Severity of Illness Index
• Young Adult

• National Natural Science Foundation of China

• COVID‐19 disease
• SARS‐CoV‐2 infection
• methanol poisoning
• outbreak

Although Moraxella catarrhalis (M. catarrhalis) is a common cause of community-acquired pneumonia (CAP), studies investigating clinical manifestations of CAP due to M. catarrhalis (MC-CAP) in adults are limited. Since S. pneumoniae is the leading cause of CAP globally, it is important to distinguish between MC-CAP and CAP due to S. pneumoniae (SP-CAP) in clinical practice. However, no past study compared clinical characteristics of MC-CAP and SP-CAP by statistical analysis. We aimed to clarify the clinical characteristics of MC-CAP by comparing those of SP-CAP, as well as the utility of sputum Gram staining.

This retrospective study screened CAP patients aged over 20 years visiting or admitted to Okinawa Miyako Hospital between May 2013 and April 2018. Among these, we included patients whom either M. catarrhalis alone or S. pneumoniae alone was isolated from their sputum by bacterial cultures.

We identified 134 MC-CAP and 130 SP-CAP patients. Although seasonality was not observed in SP-CAP, almost half of MC-CAP patients were admitted in the winter. Compared to those with SP-CAP, MC-CAP patients were older (p < 0.01) and more likely to have underlying pulmonary diseases such as asthma and bronchiectasis (p < 0.01). Approximately half of asthmatic MC-CAP and SP-CAP patients had asthma attacks. Although winter is an influenza season in Japan, co-infection with influenza virus was less common in MC-CAP compared to SP-CAP patients (3% vs. 15%, p < 0.01). Bronchopneumonia patterns on X-ray, as well as bronchial wall thickening, bilateral distribution, and segmental pattern on CT were more common in MC-CAP patients than in SP-CAP patients (p < 0.01). Sputum Gram stain was highly useful method for the diagnosis in both MC-CAP and SP-CAP (78.4% vs. 89.2%), and penicillins were most frequently chosen as an initial treatment for both pneumonias.

This is the first study to show that MC-CAP occurred in older people compared to SP-CAP, influenza virus co-infection was less common in MC-CAP than SP-CAP, and that MC-CAP frequently caused asthma attacks. Gram stain contributed for the appropriate treatment, resulting in conserving broad-spectrum antibiotics such as cephalosporins and fluoroquinolones in both MC-CAP and SP-CAP patients.

• Adult
• Asthma
• Bronchiectasis
• Bronchopneumonia pattern
• Community-acquired pneumonia
• Gram stain
• Influenza virus
• Moraxella catarrhalis
• Streptococcus pneumoniae
• Winter

Valorar la utilidad del CURB-65 para predecir la mortalidad a 30 días en pacientes adultos hospitalizados con COVID-19.

Cohorte realizada entre el 1 de marzo y el 30 de abril de 2020 en Ecuador.

Se incluyeron 247 pacientes (edad media 60 ± 14 años, 70% varones, mortalidad global 41,3%). Los pacientes con CURB-65 ≥ 2 presentaron mayor mortalidad (57 vs. 17%, p < 0,001), en asociación con otros marcadores de riesgo: edad avanzada, hipertensión arterial, sobrepeso/obesidad, fracaso renal, hipoxemia, requerimiento de ventilación mecánica o desarrollo de distrés respiratorio.

En el análisis univariado (Kaplan-Meier) y multivariado (regresión de Cox) el CURB-65 ≥ 2 se relacionó con una mayor mortalidad a 30 días.

• COVID-19
• CURB-65
• Coronavirus
• Mortality
• Pneumonia
• SARS-CoV-2

• COVID-19
• clinical characteristics
• nomogram
• prognostic factors

• 2019-nCoV
• COVID-19
• Model
• NLR
• Prognosis
• SARS-CoV

• 2019-nCoV
• COVID-19
• Model
• NLR
• Prognosis
• SARS-CoV

Patients with critical illness due to infection with the 2019 coronavirus disease (COVID-19) show rapid disease progression to acute respiratory failure. The study aimed to screen the most useful predictive factor for critical illness caused by COVID-19.

The study prospectively involved 61 patients with COVID-19 infection as a derivation cohort, and 54 patients as a validation cohort. The predictive factor for critical illness was selected using LASSO regression analysis. A nomogram based on non-specific laboratory indicators was built to predict the probability of critical illness.

The neutrophil-to-lymphocyte ratio (NLR) was identified as an independent risk factor for critical illness in patients with COVID-19 infection. The NLR had an area under receiver operating characteristic of 0.849 (95% confidence interval [CI], 0.707 to 0.991) in the derivation cohort and 0.867 (95% CI 0.747 to 0.944) in the validation cohort, the calibration curves fitted well, and the decision and clinical impact curves showed that the NLR had high standardized net benefit. In addition, the incidence of critical illness was 9.1% (1/11) for patients aged ≥ 50 and having an NLR < 3.13, and 50% (7/14) patients with age ≥ 50 and NLR ≥ 3.13 were predicted to develop critical illness. Based on the risk stratification of NLR according to age, this study has developed a COVID-19 pneumonia management process.

We found that NLR is a predictive factor for early-stage prediction of patients infected with COVID-19 who are likely to develop critical illness. Patients aged ≥ 50 and having an NLR ≥ 3.13 are predicted to develop critical illness, and they should thus have rapid access to an intensive care unit if necessary.

• 2019-nCoV
• COVID-19
• Model
• NLR
• Prognosis
• SARS-CoV