USEFULNESS OF THE COVID-GRAM AND CURB-65 SCORES FOR PREDICTING SEVERITY IN PATIENTS WITH COVID-19

Armiñanzas, Carlos; Arnaiz de las Revillas, Francisco; Gutiérrez Cuadra, Manuel; Arnaiz, Ana; Fernández Sampedro, Marta; González-Rico, Claudia; Ferrer, Diego; Mora, Víctor; Suberviola, Borja; Latorre, Maite; Calvo, Jorge; Olmos, José Manuel; Cifrián, José Manuel; Fariñas, María Carmen

PURPOSE: We studied the usefulness of COVID-GRAM and CURB-65 scores as predictors of severity of SARS-CoV-2 infection in Caucasian patients. METHODS: Retrospective observational study including all adults with SARS-CoV-2 infection admitted to our hospital from February to May 2020. Patients were stratified according to COVID-GRAM and CURB-65 scores as low-medium or high risk of critical illness. Univariate analysis, multivariate logistic regression models, receiver-operator-characteristics curve, and area under the curve were calculated. RESULTS: We included 523 patients (51.8% male; 65.63 years ([SD: 17.89 years]), of whom 110 (21%) presented critical illness (ICU admission: 10.3%; 30-day mortality: 13.8%). According to COVID-GRAM score, 122 (23.33%) patients were classified as high risk; 197 (37.7%) presented a CURB-65 ≥ 2. A significantly greater proportion of patients with critical illness had a high COVID-GRAM score (64.5% vs 30.5%; p < 0.001). COVID-GRAM score emerged as an independent predictor of critical illness (OR, 9.40; 95% CI, 5.51-16.04; p < 0.001), showing an AUC = 0.779. A high COVID-GRAM score showed an AUC = 0.88 for prediction of 30-day mortality, while a CURB-65 ≥ 2 showed an AUC = 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. CURB-65 score could be considered as an alternative.