# Predictability of Severity Scores in Patients over 70 Years Old with COVID-19 Infection: Results from a Single-Center Retrospective Observational Study

## TL;DR

This study evaluates how well different severity scores predict mortality in elderly patients with COVID-19.

## Contribution

It compares the predictive accuracy of five severity scores in patients over 70 years old with SARS-CoV-2 infection.

## Key findings

- PADUA score had the highest predictive accuracy (AUC of 0.914) for mortality in elderly patients with COVID-19.
- Tumor pathology, ICU admission, and mechanical ventilation were significant risk factors for increased mortality.
- PSI, MuLBSTA, and PADUA scores showed acceptable prediction ability for mortality in this population.

## Abstract

Background: The elderly remain a population group at risk of developing severe forms of SARS-CoV-2 infection. Age and the prevalence of comorbidities are important risk factors for mortality related to COVID-19. Severity scores enhance medical practice, proving to be useful tools in predicting mortality. Objectives: The purpose of this study is to assess the predictive accuracy of the CURB-65, Pneumonia Severity Index, MuLBSTA, COVID-GRAM and PADUA scores in patients over 70 years of age diagnosed with SARS-CoV-2 infection. Methods: We performed a retrospective study between June 2023 and December 2024, analyzing demographic data, vaccination status, comorbidities, discharge status, and computed the five scores. Results: A total of 173 patients aged over 70 years old were included in the study. Among them, 56.06% were male with a median age of 79.72 ± 6.55. Many patients had at least one comorbidity (93.06), among which hypertension (67.63%), neurological pathology (41.61%), diabetes mellitus (28.90%) and obesity (28.32%). Tumor pathology was associated with an increased risk of death. Admission to the intensive care unit and mechanical ventilation were also risk factors for increased mortality in the study population. The area under the ROC curve (AUC) of the scores (in descending order) was: 0.914 for PADUA, 0.854 for MuLBSTA, 0.831 for PSI, 0.719 for CURB-65 and 0.703 for COVID-GRAM. Conclusions: All the severity scores used were significantly higher in the non-survivor group, with PSI, MuLBSTA, and PADUA scores revealing acceptable prediction ability for mortality.