• Nicholas W Setter, Marcos L Peres, Bernardo M M de Almeida, Ricardo R Petterle, and Sonia M Raboni.
• Complexo Hospital de Clínicas, Infectious Diseases Unit, Universidade Federal do Paraná, Curitiba, Brazil.
• Intern Med J. 2020 Jun 1; 50 (6): 691-697.

BackgroundRespiratory infections are one of the leading causes of mortality, and comorbid conditions play a significant role in the severity and fatality of these infections.AimsWe evaluated the Charlson Comorbidity Index (CCI) score and possible predictors of mortality in hospitalised patients with severe acute respiratory infection (SARI), aiming to test if the CCI is a valid in-hospital prognostic indicator.MethodsPatients older than 14 years, hospitalised from 2010 to 2016 due to SARI by viral infection and who were submitted to respiratory virus testing were included. We assessed comorbidity retrospectively through chart review and calculated four variants of the CCI.ResultsOf the 291 patients assessed, 72.8% (n = 212) presented comorbidities, and 24% died (n = 70). The most recurrent comorbidities were chronic pulmonary disease (n = 76/212, 36%) and HIV (n = 50/212, 23.6%). The 1994 age-adjusted CCI predicted in-hospital mortality in SARI patients (P = 0.04), and HIV was associated with in-hospital mortality (P = 0.032).ConclusionsThe comorbidity scores used to assess mortality risk in hospitalised patients with SARI displayed poor results, but HIV infection was considered a marker of severity. However, other factors should be considered in order to compose a score system that allows us to specifically assess the risk of mortality in patients with SARI.© 2019 Royal Australasian College of Physicians.

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