Evaluation of SOFA, qSOFA, CURB-65 and 4C mortality scoring systems in patients with COVID-19 pneumonia admitting to the Emergency Department

Objective: This study evaluated the relationship between SOFA, qSOFA, CURB-65, and 4C Mortality scores and mortality in patients with COVID-19 pneumonia admitted to the emergency department. Materials and Methods: In this single-center, prospective, observational cohort study conducted between March 2022 and September 2022, patients who presented to the emergency department, underwent thoracic computed tomography in the presence of clinical indication, had a positive COVID-19 polymerase chain reaction (PCR) test and had pneumonia were included. Sociodemographic characteristics, laboratory parameters, clinical severity, SOFA, qSOFA, CURB-65, 4C mortality scores, and clinical outcomes were recorded. The relationship between all scoring systems and 30-day mortality was evaluated. Results: The study included 160 patients. Of these, 81 (50.6%) were female and 79 (49.4%) were male. The mean age of the patients was 71.19±17.28 years. All patients were hospitalized. Of 160 patients, 75 (46.9%) were hospitalized in the ward, and 85 (53.1%) were hospitalized in the intensive care unit. The mortality rate was 32.3% (n=50). The mean age of the patients who developed mortality was 78.12±12.69, while the mean age of the patients who did not develop mortality was 68.05±18.20 (p<0.001). When the specified scoring values of the patients were analyzed, the median value of SOFA score was 3 (Min:0-Max:12), the median value of qSOFA score was 2 (Min:0-Max:3), the median value of 4C Mortality score was 14.5 (Min:2-Max:21), and the median value of CURB-65 score was 3 (Min:1-Max:5). SOFA, qSOFA, CURB-65 and 4C Mortality scores were significantly higher in patients with mortality compared to those without mortality (p<0.001 for each). In addition, there was a moderate positive correlation between all these scoring systems and mortality (p<0.001; for each) (r for SOFA: 0.480 for SOFA, r for qSOFA: 0.382, r: 0.374 for CURB-65 and r: 0.354 for 4C Mortality score). Conclusion: Although there are retrospective studies conducted similarly before when the literature was analyzed, this study is the first prospective study conducted in emergency department conditions and evaluating the relationship between various scoring systems and mortality in patients with COVID-19 pneumonia. According to our results, higher SOFA, qSOFA, CURB-65, and 4C Mortality scores can be used as an indicator for mortality.