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Low CRB-65 scores effectively rule out adverse clinical outcomes in COVID-19 irrespective of chest radiographic abnormalities
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dc.contributor.author | Liu, Alexander Qichen | |
dc.contributor.author | Hammond, Robert | |
dc.contributor.author | Chan, Kenneth | |
dc.contributor.author | Chukwuenweniwe, Chukwugozie | |
dc.contributor.author | Johnson, Rebecca | |
dc.contributor.author | Khair, Duaa | |
dc.contributor.author | Duck, Eleanor | |
dc.contributor.author | Olubodun, Oluwaseun | |
dc.contributor.author | Barwick, Kirstian | |
dc.contributor.author | Banya, Winston | |
dc.contributor.author | Stirrup, James | |
dc.contributor.author | Donnelly, Peter Duncan | |
dc.contributor.author | Kaski, Juan Carlos | |
dc.contributor.author | Coates, Anthony R M | |
dc.date.accessioned | 2023-08-30T10:30:14Z | |
dc.date.available | 2023-08-30T10:30:14Z | |
dc.date.issued | 2023-08-30 | |
dc.identifier | 293053342 | |
dc.identifier | 81a8d490-2965-48fc-9013-2220f847a081 | |
dc.identifier | 85172933062 | |
dc.identifier.citation | Liu , A Q , Hammond , R , Chan , K , Chukwuenweniwe , C , Johnson , R , Khair , D , Duck , E , Olubodun , O , Barwick , K , Banya , W , Stirrup , J , Donnelly , P D , Kaski , J C & Coates , A R M 2023 , ' Low CRB-65 scores effectively rule out adverse clinical outcomes in COVID-19 irrespective of chest radiographic abnormalities ' , Biomedicines , vol. 11 , no. 9 , 2423 . https://doi.org/10.3390/biomedicines11092423 | en |
dc.identifier.issn | 2227-9059 | |
dc.identifier.other | RIS: urn:7E7FBB6BB75DA9448B41AA7368955999 | |
dc.identifier.other | ORCID: /0000-0003-3664-3641/work/157140945 | |
dc.identifier.uri | https://hdl.handle.net/10023/28261 | |
dc.description.abstract | Background: CRB-65 ( C onfusion; R espiratory rate ≥ 30/min; B lood pressure ≤ 90/60 mmHg; age ≥ 65 years) is a risk score for prognosticating patients with COVID-19 pneumonia. However, a significant proportion of COVID-19 patients have normal chest X-rays (CXRs). The influence of CXR abnormalities on the prognostic value of CRB-65 is unknown, limiting its wider applicability. Methods: We assessed the influence of CXR abnormalities on the prognostic value of CRB-65 in COVID-19. Results: In 589 study patients (71 years (IQR: 57–83); 57% males), 186 (32%) had normal CXRs. On ROC analysis, CRB-65 performed similarly in patients with normal vs. abnormal CXRs for predicting inpatient mortality (AUC 0.67 ± 0.05 vs. 0.69 ± 0.03). In patients with normal CXRs, a CRB-65 of 0 ruled out mortality, NIV requirement and critical illness (intubation and/or ICU admission) with negative predictive values (NPVs) of 94%, 98% and 99%, respectively. In patients with abnormal CXRs, a CRB-65 of 0 ruled out the same endpoints with NPVs of 91%, 83% and 86%, respectively. Patients with low CRB-65 scores had better inpatient survival than patients with high CRB-65 scores, irrespective of CXR abnormalities (all p < 0.05). Conclusions: CRB-65, CXR and CRP are independent predictors of mortality in COVID-19. Adding CXR findings (dichotomised to either normal or abnormal) to CRB-65 does not improve its prognostic accuracy. A low CRB-65 score of 0 may be a good rule-out test for adverse clinical outcomes in COVID-19 patients with normal or abnormal CXRs, which deserves prospective validation. | |
dc.format.extent | 1567996 | |
dc.language.iso | eng | |
dc.relation.ispartof | Biomedicines | en |
dc.subject | Coronavirus disease 2019 | en |
dc.subject | CRB-65 | en |
dc.subject | Chest X-ray | en |
dc.subject | Diagnostic performance | en |
dc.subject | Inflammatory markers | en |
dc.subject | Prognosis | en |
dc.subject | Risk stratification | en |
dc.subject | COVID-19 | en |
dc.subject | RA0421 Public health. Hygiene. Preventive Medicine | en |
dc.subject | E-NDAS | en |
dc.subject.lcc | RA0421 | en |
dc.title | Low CRB-65 scores effectively rule out adverse clinical outcomes in COVID-19 irrespective of chest radiographic abnormalities | en |
dc.type | Journal article | en |
dc.contributor.institution | University of St Andrews. School of Medicine | en |
dc.contributor.institution | University of St Andrews. Infection and Global Health Division | en |
dc.identifier.doi | 10.3390/biomedicines11092423 | |
dc.description.status | Peer reviewed | en |
dc.identifier.url | https://www.mdpi.com/2227-9059/11/9/2423 | en |
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