Last review and update: June 27, 2020.
A short summary:
Systolic blood pressure below 90mmHg is an indicator of pneumonia severity. This indicator is valid also in COVID-19.
Systolic blood pressure below 90mmHg in the CRB-65 score.
Wang et al., 2020 (3):
Assessment of pneumonia severity with CRB-65 is a generally-accepted tool used for assessing the severity of pneumonia because of its simplicity and effectiveness.
The CRB-65 score stands for: C, mental confusion; R, respiratory rate >or=30/min; B, systolic blood pressure <90 mm Hg or diastolic blood pressure <or=60 mm Hg; 65, age >or=65 years (1).
The risk classes are according to Ewig et al., 2008 (1) and Lim et al., 2003 (2) are defined as follows: risk class (RC) 1 (CRB-65 = 0 points); RC 2 (CRB-65 = 1 or 2 points); RC 3 (CRB-65 = 3 or 4 points or mechanical ventilation at admission, since no reliable assessment of respiratory rate is realistic in these latter patients). CRB-65 score 0, 1–2 and 3–4 are, respectively, representative of mild, moderate and severe pneumonia (3).
Wang et al., 2020 (3), found that CBR-65 score was an independent predictor of COVID-19 mortality within 28 days:
It is of note also, that blood glucose above 7mmol/L was found to be an independent predictor of COVID-19 mortality (see the table above from Wang et al., 2020 (3).
Conclusions.
Hospitalization implies exposure to medical malpractice. There is currently a lot of malpractice in the treatment of COVID-19. Simple indicators of COVID-19 severity are therefore useful to determine cases where hospitalization is really necessary.
The chances of recovery are much higher if the medical team at the hospital where a COVID-19 patient is hospitalized is qualified. If you need help in assessing the situation in hospitals near you, do not hesitate to get in contact with us.
Selected references:
1. Ewig S, Birkner N, Strauss R, et al. New perspectives on community-acquired pneumonia in 388 406 patients. Results from a nationwide mandatory performance measurement programme in healthcare quality. Thorax. 2009;64(12):1062-1069. doi:10.1136/thx.2008.109785
2. Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax 2003;58:377–382
3. Wang (Sufei) et al. Fasting blood glucose at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes: a multi-centre retrospective study. DIABETOLOGIA IN PRESS v.1.1. Received: 17 April 2020 / Accepted: 10 June 2020
DOI: 10.1007/s00125-020-05209-1