Applicability of the CURB-65 pneumonia severity score for outpatient treatment of COVID-19

J Infect. 2020 Sep;81(3):e96-e98. doi: 10.1016/j.jinf.2020.05.049. Epub 2020 May 29.


Objectives: The CURB-65 is a severity score to predict mortality secondary to community acquired pneumonia and is widely used to identify patients who can be managed as outpatients. However, whether CURB-65 can be applicable to COVID-19 patients for the decision of outpatient treatment is still unknown.

Methods: We conducted a retrospective single-centre study assessing the performance of the CURB-65 to predict the risk of poor outcome, defined as the need for mechanical ventilation and/or death, among patients hospitalized for COVID-19. The association between the CURB-65 and the outcome was assessed by a univariable Cox proportional hazard regression model.

Results: A total of 279 patients were hospitalized between March 15th and April 14th, 2020. According to the CURB-65, 171 (61.3%) patients were considered at low risk (CURB-65 01), 66 (23.7%) at intermediate risk (CURB-65=2), and 42 (15.1%) had high risk of 30-day mortality (CURB-65 35). During the study period, 88 (31.5%) patients had a poor outcome. The CURB-65 was strongly associated with a poor outcome (Pfor linear trend <0.001). However, among patients with a CURB-65 of 01, thus considered at low risk, 36/171 (21.1%) had a poor outcome.

Conclusions: Our study suggests that the applicability of CURB-65 to guide the decision of inpatient or outpatient care is scarce, as it does not safely identify patients who could be managed as outpatients.

Keywords: COVID-19; CURB-65; Outpatient care; Risk factor.

Publication types

  • Letter
  • Comment

MeSH terms

  • Ambulatory Care
  • Betacoronavirus
  • COVID-19
  • Community-Acquired Infections*
  • Coronavirus Infections*
  • Coronavirus*
  • Humans
  • Outpatients
  • Pandemics*
  • Pneumonia*
  • Pneumonia, Viral*
  • Retrospective Studies
  • SARS-CoV-2
  • Severity of Illness Index
  • United Kingdom