Reliability of the Pneumonia Severity Score (PSI) Index in Patients Diagnosed with COVID-19 Pneumonia to Determine Outpatient Discharge
1Ministry of Health, Ankara City Hospital Emergency Medicine Clinic, Ankara, Turkey
2Dışkapı Yıldırım Beyazıt Education and Research Hospital, Emergency Medicine Clinic, Ankara, Turkey
3Ministry of Health, Ankara, Turkey
Online publish date: 14 October 2020
Objectives: Covid-19 infection, which has plagued the whole world, leads to deaths with a heavy pneumonia manifestation. Smoking, male gender and age stand out among the poor prognostic criteria of the disease. However, we still do not have a reliable scoring system for this disease. In this study, we aimed to find a reliable score at home discharge by using the Pneumonia severity index (PSI). Methods: Patients who came with suspected covid-19 in May were prospectively examined. The PSI scores of the patients at the time of admission to the emergency department were calculated. The PSI score of 161 patients included in our study was divided into 2 groups as 18 - 49 years of age (group 1) and 50 and above (group 2). The clinical course of these patients was followed for 30 days. Data were associated with oxygen supplementation, need for intensive care, and mortality. Results: PSI score was significantly higher in group 1 males than females (p < 0.001). There was no difference over 50 years old (p = 0.571). The length of stay of group 2 patients was found to be significantly higher (p = 0.041). This may make us think that the treatment process becomes more difficult with age. The PSI scores of the 53 male patients were in Class 1, and those of the 42 female patients were Class 1. Among the patients who had the risk of 2 or more in Class 2 who were over the age of 50, 10 needed nasal oxygen, and 3 of these were transferred to Intensive Care Unit. Only one patient died. Conclusions: Patients over the age of 50 can be hospitalized if their PSI score is above 70, while patients under 50 can be followed up with home treatment. Group 2 patients without any additional disease can be followed up by telemedicine method.
Covid-19, Pneumonia, PSI
Ahmet Burak Erdem,Hakan Oğuztürk,Miray Tümer,Bahattin Işık,Afsin Emre Kayipmaz,Semih Korkut. Reliability of the Pneumonia Severity Score (PSI) Index in Patients Diagnosed with COVID-19 Pneumonia to Determine Outpatient Discharge. Signa Vitae. 2020.doi:10.22514/sv.2020.16.0074.
 Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507–513.
 Liu K, Chen Y, Lin R, et al. Clinical features of COVID-19 in elderly patients: A comparison with and middle-aged patients. J Infect. 2020;80:e14-e18.
 Kim M-A, Park JS, Lee CW, et al. Pneumonia severity index in viral community acquired pneumonia in adults. PLoS One. 2019;14:e0210102.
 Marcos PJ, Restrepo MI, González-Barcala FJ, et al. Discordance of physician clinical judgment vs. pneumonia severity index (PSI) score to admit patients with low risk community acquired pneumonia: a prospective multicenter study. J Thorac Dis. 2017;9:1538-1546.
 Renaud B, Coma E, Labarere J, et al. Routine Use of the Pneumonia Severity Index for Guiding the Site-of-Treatment Decision of Patient with Pneumonia in the Emergency Department: A Multicenter, Prospective, Observational, Controlled Cohort Study. Clin Infect Dis. 2007;44:41-49.
 Shi Y, Yu X, Zhao H, et al. Host susceptibility to severe COVID-19 and establishment of a host risk score: findings of 487 cases outside Wuhan. Crit Care. 2020;24:108.
 Seymann, G, Barger K, Choo S, et al. Clinical judgment versus the pneumonia severity index in making the admission decision. J Emerg Med. 2008;34:261–268.
 Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054–1062.
 Zheng Z, Peng F, Xu B, et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infec. 2020;81:e16-e25.
 Liu W, Tao ZW, Wang L, et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chin Med J (Engl). 2020;133:1032-1038.
 Deng Y, Liu W, Liu K, et al. Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study. Chin Med J (Engl). 2020;133:1261-1267.
 Mo P, Xing Y, Xiao Y, et al. Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China. Clin Infect Dis. 2020. doi: 10.1093/cid/ciaa270.
 Henry BM, Oliveira MHS, Benoit S, et al. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020;58:1021-1028.
 Hu H, Yao N, Qiu Y. Comparing rapid scoring systems in mortality prediction of critical ill patients with novel coronavirus disease. Acad Emerg Med. 2020;27:461-468.
 Ji D, Zhang D, Xu J, et al. Prediction for Progression Risk in Patients with COVID-19 Pneumonia: the CALL Score. Clin Infect Dis. 2020;71:1393-1399.
Science Citation Index Expanded (SciSearch) The Science Citation Index (SCI) is a citation index originally produced by the Institute for Scientific Information (ISI) and created by Eugene Garfield. It (Science Citation Index Expanded) covers more than 8,500 notable and significant journals, across 150 disciplines in science and technology, from 1900 to the present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.
IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.
Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.
Scopus Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.