The following is a summary of “Prognostication of COVID-19 patients using ROX index and CURB-65 score – A retrospective observational study” published in the October 2022 issue of Family Medicine and Primary Care by Arora et al.


The global healthcare system is completely overrun by the 2019 coronavirus disease-2019 (COVID-19). Patient mortality increased as a result of the lack of intensive care unit (ICU) beds. Patients who were overcrowded experienced higher death rates, longer hospital stays, and higher healthcare expenses. It was possible to allocate hospital resources judiciously through the proper categorization of patients. Numerous scores have been explored for risk classification of patients, but for a score to be helpful at the primary care level, it should be accessible at the bedside and repeatable. The ROX index and CURB-65 are straightforward bedside ratings that may be computed with the barest of tools and research.

Adult patients who came to the emergency department (ED) between May 1 and November 30, 2020, with confirmed COVID-19 infection, were included in the retrospective, record-based investigation. Clinical and demographic information about the patient was gleaned from the hospital’s computerized medical records. A correlation between the ROX index and CURB-65 score at the time of ED entry and the requirement for hospitalization, as well as early (14-day) and late (28-day) mortality, was found.

The research had 842 patients in all. Patients who had mild, moderate, or severe illness made up, respectively, 46.3%, 14.9%, and 38.8% of the patient population. 55% of patients needed to be hospitalized. Mortality rates at 14 and 28 days were 8.8% and 20.7%, respectively. The AUROC of the ROX index was 0.924 (P<0.001) for predicting hospitalization, 0.909 (P< 0.001) for predicting mortality after 14 days, and 0.933 (P< 0.001) for predicting death after 28 days. The AUROC of CURB-65 score was 0.845, (P< 0.001) for predicting hospitalization, 0.905 (P< 0.001) for predicting mortality after 14 days, and 0.902 (P< 0.001) for predicting death after 28 days. The cut-off value for the ROX index was ≤18.634 for predicting hospitalization and ≤14.122 for predicting 14-day mortality. The CURB-65 score had similar cut-off values of ≥1, and ≥2, respectively.

Primary care providers can effectively use the ROX index and CURB-65 scores for effective risk stratification of patients with COVID-19 infection. Both scores are easy to use and reasonably priced.

Reference: journals.lww.com/jfmpc/Fulltext/2022/10000/Prognostication_of_COVID_19_patients_using_ROX.20.aspx