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Multigrain/polydispersity has a significant impact on turbidity current (TC). Despite the fact that several researches have looked into this effect, the impact of the fluid–particle interactions is not fully understood. Motivated by this, we employ the Eulerian–Lagrangian computational fluid dynamics–discrete element method model to investigate the dynamics of the bidisperse lock-exchange TC. Results show that, because the coarse particles will settle faster and stop moving forward, the two phases of bidisperse transport and fine component transport can be distinguished in the evolution of the bidisperse TC. During the bidisperse transport stage, the upper interface of each component is primarily determined by their own settling and transport characteristics and does not strongly depend on the relative fine particle volume fraction $\phi _F$. Fine particles are primarily responsible for the vortical structures near the upper interface of the TC head, and the increase of $\phi _F$ promotes their streamwise development. In comparison, fragmented vortical coherent structures are closely related to the presence of coarse particles, which can be seen in the lower layers. Bidisperse segregation alters the collision process between dispersed phases, which differs from monodisperse TC. The collisions and segregation-induced flow establish interconnections between the two dispersed phases. In the latter stage, the transport of fine particles is inhibited by both the lift force and the contact force produced by the collision with the deposited materials. As $\phi _F$ rises, the negative contact force weakens, and its change is essentially balanced by the rise in negative lift force.
The turbidity current (TC), a ubiquitous fluid–particle coupled phenomenon in the natural environment and engineering, can transport over long distances on an inclined terrain due to the suspension mechanism. A large-eddy simulation and discrete element method coupled model is employed to simulate the particle-laden gravity currents over the inclined slope in order to investigate the auto-suspension mechanism from a Lagrangian perspective. The particle Reynolds number in our TC simulation is $0.01\sim 0.1$ and the slope angle is $1/20 \sim 1/5$. The influences of initial particle concentration and terrain slope on the particle flow regimes, particle movement patterns, fluid–particle interactions, energy budget and auto-suspension index are explored. The results indicate that the auto-suspension particles predominantly appear near the current head and their number increases and then decreases during the current evolution, which is positively correlated with the coherent structures around the head. When the turbidity current propagates downstream, the average particle Reynolds number of the auto-suspension particles remains basically unchanged, and is higher than that of other transported particles. The average particle Reynolds number of the transported particles exhibits a negative correlation with the Reynolds number of the current. Furthermore, the increase in particle concentration will enhance the particle velocity, which allows the turbidity current to advance faster and improves the perpendicular support, thereby increasing the turbidity current auto-suspension capacity. Increasing slope angle will result in a slightly larger front velocity, while the effect of that on the total force is insignificant.
In strong-field physics experiments with ultraintense lasers, a single-shot cross-correlator (SSCC) is essential for fast optimization of the pulse contrast and meaningful comparison with theory for each pulse shot. To simultaneously characterize an ultrashort pulse and its long pedestal, the SSCC device must have both a high resolution and a large temporal window. However, the resolution and window in all kinds of single-shot measurement contradict each other in principle. Here we propose and demonstrate a novel SSCC device with two separate measurement channels: channel-1 for the large-window pedestal measurement has a moderate resolution but a large window, while channel-2 for the ultrashort pulse measurement has a small window but a high resolution; this allows the accurate characterization of the pulse contrast in a single shot. A two-channel SSCC device with a 200-fs resolution and 114-ps window has been developed and tested for its application in ultraintense lasers at 800 nm.
Whether starchy and non-starchy vegetables have distinct impacts on health remains unknown. We prospectively investigated the intake of starchy and non-starchy vegetables in relation to mortality risk in a nationwide cohort. Diet was assessed using 24-h dietary recalls. Deaths were identified via the record linkage to the National Death Index. Hazard ratios (HR) and 95 % CI were calculated using Cox regression. During a median follow-up of 7·8 years, 4904 deaths were documented among 40 074 participants aged 18 years or older. Compared to those with no consumption, participants with daily consumption of ≥ 1 serving of non-starchy vegetables had a lower risk of mortality (HR = 0·76, 95 % CI 0·66, 0·88, Ptrend = 0·001). Dark-green and deep-yellow vegetables (HR = 0·79, 95 % CI 0·63, 0·99, Ptrend = 0·023) and other non-starchy vegetables (HR = 0·80, 95 % CI 0·70, 0·92, Ptrend = 0·004) showed similar results. Total starchy vegetable intake exhibited a marginally weak inverse association with mortality risk (HR = 0·89, 95 % CI 0·80, 1·00, Ptrend = 0·048), while potatoes showed a null association (HR = 0·93, 95 % CI 0·82, 1·06, Ptrend = 0·186). Restricted cubic spline analysis suggested a linear dose–response relationship between vegetable intake and death risk, with a plateau at over 300 and 200 g/d for total and non-starchy vegetables, respectively. Compared with starchy vegetables, non-starchy vegetables might be more beneficial to health, although both showed a protective association with mortality risk. The risk reduction in mortality plateaued at approximately 200 g/d for non-starchy vegetables and 300 g/d for total vegetables.
This study aimed to analyze the clinical effects of microdissection testicular sperm extraction (micro-TESE) surgery combined with an intracytoplasmic sperm injection (ICSI) regimen in the treatment of non-obstructive azoospermia (NOA) patients with different etiologies. In total, 128 NOA patients participated in this study, in which they received infertility treatment by micro-TESE surgery combined with an ICSI regimen, and all patients were divided into three groups [the Klinefelter syndrome (KS), the idiopathic and the secondary NOA groups]. In addition, the sperm retrieval rate (SRR), fertilization rate, embryo development status and clinical treatment effects were analyzed. Among the 128 NOA patients, the SRR of KS NOA patients was 48.65%, those of idiopathic and the secondary patients were 33.82% and 73.91%, respectively. Regardless of etiologies, there was no correlation with age, hormone value or testicular volume. Further analysis showed that the SRR of the KS group was positively related with testosterone (T) values, and the SRR of the secondary group had a positive relationship with follicle-stimulating hormone or luteinizing hormone values. In the subsequent clinical treatment, the retrieved sperm was subjected to ICSI and achieved good treatment effects, especially in the secondary group, and the implantation rate (55.56%) and clinical pregnancy rate (68.42%) were both higher than those of the idiopathic group (28.75% and 40.00%) and KS group (22.05% and 30.77%). Micro-TESE surgery combined with ICSI insemination is the most effective treatment regimen for NOA patients. The SRR of NOA patients with different etiologies are related to certain specific factors, and micro-TESE surgery seems to be the ideal and only way to have biological children.
To investigate spiritual care perceptions, spiritual well-being, and empathy, examine the correlations among spiritual care perceptions, spiritual well-being, and empathy, and explore the mediating role of spiritual well-being between other two variables of Chinese nursing students.
A cross-sectional design was implemented, and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist was used to ensure quality reporting of the study. A cluster sample of 2,718 nursing students was selected from 7 universities and colleges in China. The demographic characteristics questionnaire, the Chinese Version of the Spiritual Care-Giving Scale (C-SCGS), the Spiritual Health Scale Short Form (SHS-SF), and the Jefferson Scale of Physician Empathy-Nursing Student (JSPE-NS) were used. Descriptive statistics, correlation, and process plug-in mediation effect analyses were used to analyze the data.
The total score of spiritual care perceptions, spiritual well-being, and empathy were 173.83 ± 25.62, 98.74 ± 12.87, and 105.04 ± 21.34, respectively. Spiritual care perceptions were positively correlated with spiritual well-being (r = 0.617, p < 0.01) and empathy (r = 0.528, p < 0.01). And spiritual well-being played a partial mediating role between the other two variables (accounting for 28.1%).
Significance of results
Spiritual care perceptions, spiritual well-being, and empathy were quite moderate, which need in improving. It is suggested that nursing educators pay attention to the spiritual care education of nursing students, perfect the spiritual care education system, and take targeted measures according to nursing students’ individual personality traits and differences, improve their spiritual well-being and empathy in multiple ways, so as to improve their spiritual care perceptions and competence.
The purpose of the current study was to research the factors influencing thyroid volume (TVOL) in 6–12-year-old children and update the reference values. A cross-sectional study was carried out in iodine-sufficient areas of four provinces in China. Urine, edible salt and drinking water samples were collected from children. Children’s height, weight and TVOL were measured. Ridge regression was used to screen variables for solving the multicollinearity problem. Quantile regression was used to analyse the relationship between the quantiles of TVOL and other variables. In total, 5653 children aged 6–12 years were enrolled in this study, including 2838 boys and 2815 girls. There was no significant difference in TVOL between boys and girls (P > 0·05). Spearman correlation analysis showed that total TVOL was positively correlated with age, height, weight, body surface area (BSA) and BMI, and the correlation coefficients were 0·616, 0·663, 0·669, 0·685 and 0·479, respectively. Among them, the correlation between TVOL and BSA was the strongest. According to the ridge regression results, age and BSA influenced TVOL, and the ridge regression coefficients were 0·13 and 0·94, respectively. Quantile regression further showed that age and BSA had significant influences on the whole TVOL distribution (P < 0·001). Therefore, the TVOL of children aged 6–12 years in China was mainly influenced by age and BSA, and reference values for TVOL of different genders based on age and BSA were established.
The trilobite Liostracina has been recognized as important in taxonomic and stratigraphic studies for more than a century. Until now, the genus Liostracina and family Liostracinidae have been known from only incomplete holaspid material, a degree 2 meraspis, and protaspides. A new locality in the Longha Formation (Cambrian: Guzhangian) of southeastern Yunnan, China, yields a rich collection of articulated holaspid exoskeletons and disarticulated sclerites of a new species, Liostracina fuluensis n. sp. These specimens reveal thoracic and ventral morphology that was previously unknown for Liostracina; they demonstrate that it has a rostral plate plus rostral and connective sutures, rather than a ventral median suture on the cephalic doublure. This confirms a natant hypostomal condition for the genus. Holaspid exoskeletal features, combined with evidence of a non-asaphoid-type protaspis, indicate that Liostracina is neither a primitive trinucleoid nor a primitive asaphoid. The family Liostracinidae is excluded from the superfamily Trinucleoidea and the order Trinucleida and reassigned to the order Ptychopariida.
Later Cambrian and earliest Ordovician trilobites and brachiopods spanning eight horizons from five localities within the Sông Mã, Hàm Rồng and Đông Sơn formations of the Thanh Hóa province of Việt Nam, constrain the age and faunal affinities of rocks within the Sông Đà terrane, one of several suture/fault-bounded units situated between South China to the north and Indochina to the south. ‘Ghost-like’ preservation in dolomite coupled with tectonic deformation leaves many of the fossils poorly preserved, and poor exposure precludes collecting within continuously exposed stratigraphic successions. Cambrian carbonate facies pass conformably into Lower Ordovician carbonate-rich strata that also include minor siliciclastic facies, and the recovered fauna spans several uppermost Cambrian and Lower Ordovician biozones. The fauna is of equatorial Gondwanan affinity, and comparable to that from South China, North China, Sibumasu and Australia. A new species of Miaolingian ‘ptychopariid’ trilobite, Kaotaia xuanensis, is described. Detrital zircon samples from Cambrian–Ordovician rocks of the North Việt Nam and Sông Đà terranes, and from Palaeozoic samples from the Trường Sơn sector of Indochina immediately to the south, contain a predominance of ages spanning the Neoproterozoic period and have a typical equatorial Gondwanan signature. We associate the Cambrian and Tremadocian of the Sông Đà terrane with areas immediately to the north of it, including the North Việt Nam terrane and the southern parts of Yunnan and Guangxi provinces of China.
The findings regarding the associations between red meat, fish and poultry consumption, and the metabolic syndrome (Mets) have been inconclusive, and evidence from Chinese populations is scarce. A cross-sectional study was performed to investigate the associations between red meat, fish and poultry consumption, and the prevalence of the Mets and its components among the residents of Suzhou Industrial Park, Suzhou, China. A total of 4424 participants were eligible for the analysis. A logistic regression model was used to estimate the OR and 95 % CI for the prevalence of the Mets and its components according to red meat, fish and poultry consumption. In addition, the data of our cross-sectional study were meta-analysed under a random effects model along with those of published observational studies to generate the summary relative risks (RR) of the associations between the highest v. lowest categories of red meat, fish and poultry consumption and the Mets and its components. In the cross-sectional study, the multivariable-adjusted OR for the highest v. lowest quartiles of consumption was 1·23 (95 % CI 1·02, 1·48) for red meat, 0·83 (95 % CI 0·72, 0·97) for fish and 0·93 (95 % CI 0·74, 1·18) for poultry. In the meta-analysis, the pooled RR for the highest v. lowest categories of consumption was 1·20 (95 % CI 1·06, 1·35) for red meat, 0·88 (95 % CI 0·81, 0·96) for fish and 0·97 (95 % CI 0·85, 1·10) for poultry. The findings of both cross-sectional studies and meta-analyses indicated that the association between fish consumption and the Mets may be partly driven by the inverse association of fish consumption with elevated TAG and reduced HDL-cholesterol and, to a lesser extent, fasting plasma glucose. No clear pattern of associations was observed between red meat or poultry consumption and the components of the Mets. The current findings add weight to the evidence that the Mets may be positively associated with red meat consumption, inversely associated with fish consumption and neutrally associated with poultry consumption.
Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.
In this study, a high-energy, temporally shaped picosecond ultraviolet (UV) laser running at 100 Hz is demonstrated, with its pulses boosted to 120 mJ by cascaded regenerative and double-pass amplifiers, resulting in a gain of more than 108. With precise manipulation and optimization, the amplified laser pulses were flat-top in the temporal and spatial domains to maintain high filling factors, which significantly improved the conversion efficiency of the subsequent third harmonic generation (THG). Finally, 91 mJ, 470 ps pulses were obtained at 355 nm, corresponding to a conversion efficiency as high as 76%, which, as far as we are aware of, is the highest THG efficiency for a high-repetition-rate picosecond laser. In addition, the energy stability of the UV laser is better than 1.07% (root mean square), which makes this laser an attractive source for a variety of fields including laser conditioning and micro-fabrication.
This study examines the effects of an old-age allowance programme in Taiwan, the Senior Citizens Welfare Living Allowance (SCWLA), on intergenerational financial transfers, living arrangements and contact, as well as the heterogeneity of its effects by adult children’s five types of motives for giving: altruism, exchange, reciprocity, affection, and sense of responsibility. Using 2002, 2004, 2005 and 2006 data from the Panel Study of Family Dynamics, we employed a difference-in-difference individual fixed effect model to compare the outcomes across the treatment (aged 65 and older) and comparison groups (aged 55 to 64) before and after the introduction of SCWLA. Our results indicate that SCWLA crowds in intergenerational contact but does not significantly change financial transfers and co-residence patterns. The increase in intergenerational contact is primarily driven by adult children having lower motives for giving. This suggests that old-age allowances may reduce financial entanglement between adult children and older parents and change the social norm by raising “low motivators’” awareness, respect and concern for elderly. Providing public transfer to the elderly should not be hampered by the fear of distorting family support functions.
The association between blood transfusion and ventilator-associated events (VAEs) has not been fully understood. We sought to determine whether blood transfusion increases the risk of a VAE.
Nested case-control study.
This study was based on a registry of healthcare-associated infections in intensive care units at West China Hospital system.
1,657 VAE cases and 3,293 matched controls were identified.
For each case, 2 controls were randomly selected using incidence density sampling. We defined blood transfusion as a time-dependent variable, and we used weighted Cox models to calculate hazard ratios (HRs) for all 3 tiers of VAEs.
Blood transfusion was associated with increased risk of ventilator-associated complication-plus (VAC-plus; HR, 1.47; 95% CI, 1.22–1.77; P <.001), VAC-only (HR, 1.29; 95% CI, 1.01–1.65; P = .038), infection-related VAC-plus (IVAC-plus; HR, 1.78; 95% CI, 1.33–2.39; P < .001), and possible ventilator-associated pneumonia (PVAP; HR, 2.10; 95% CI, 1.10–3.99; P = .024). Red blood cell (RBC) transfusion was also associated with increased risk of VAC-plus (HR, 1.34; 95% CI, 1.08–1.65; P = .007), IVAC-plus (HR, 1.70; 95% CI, 1.22–2.36; P = .002), and PVAP (HR, 2.49; 95% CI, 1.17–5.28; P = .018). Compared to patients without transfusion, the risk of VAE was significantly higher in patients with RBC transfusions of >3 units (HR, 1.73; 95% CI, 1.25–2.40; P = .001) but not in those with RBC transfusions of 0–3 units.
Blood transfusions were associated with increased risk of all tiers of VAE. The risk was significantly higher among patients who were transfused with >3 units of RBCs.
Drilling and sampling are the most direct and effective methods available to study Antarctic subglacial lakes. Based on the Philberth probe, a Recoverable Autonomous Sonde (RECAS) allows for in situ lake water measurement and sampling, through the addition of an upper thermal tip and a cable recoiling mechanism. RECAS-200, a prototype of RECAS, has a drilling depth of 200 m, a surface supply voltage of 800 VAC and a downhole power of ~9.6 kW during drilling. In this study, a heating control system for RECAS-200 was designed. The system avoids the need for high-power step-down converters, by separating heating power from control power, thereby reducing the overall weight of the probe and avoiding the need to increase cable diameter. We also introduce a self-developed, small, solid-state, 800 VAC power regulator and a fuzzy PID temperature control algorithm. Their purpose was to manage the power adjustment of each heating element and to provide closed-loop temperature control of certain heating elements which can easily burn out due to overheating. Test results indicated that the proposed RECAS-200 heating control system met all our design specifications and could be easily assembled into the RECAS-200 probe.
Anaemia is a global public health problem affecting women worldwide, and reproductive-age women are at increased risk. We conducted a population-based cross-sectional study analysing the prevalence of overall anaemia and anaemia according to severity in Chinese pre-pregnant women to update current knowledge on anaemia epidemiology. Based on the National Free Preconception Check-up Projects supported by the Chinese government, 5 679 782 women participating in this project in 2017 were included in the present study. The cyanmethemoglobin method was applied to assess Hb concentrations. Univariate and multivariate logistic regressions were applied for associated factors. The prevalence of anaemia among Chinese pre-pregnant women was 21·64 % (mild: 14·10 %, moderate: 7·17 % and severe : 0·37 %). The prevalence of overall and severe anaemia was the highest in Tibet and the lowest in Beijing among thirty-one provinces. Women’s age, region, ethnic origin, educational level, occupation and pregnancy history were all correlated with anaemia. Women with B blood type (adjusted OR (aOR) = 0·89), higher BMI (overweight: aOR = 0·84; obesity: aOR = 0·70) and alcohol consumption (aOR = 0·69) were less likely to have anaemia, while those with rhesus negative blood type (aOR = 1·10), history of anaemia (aOR = 2·60), older age at menarche (aOR = 1·19), heavy menstrual blood loss (aOR = 1·39), longer menstrual period (aOR = 1·09) and shorter menstrual cycle (aOR = 1·08) were more likely to suffer from anaemia. Meat or egg eaters were not significantly associated with severe anaemia. Anaemia is of moderate public health significance among Chinese pre-pregnant women. Interventions should be considered to prevent anaemia to the greatest extent possible to avoid potential harm in this population.
Subglacial lake exploration is of great interest to the science community. RECoverable Autonomous Sonde (RECAS) provides an exploration tool to measure and sample subglacial lake environments while the subglacial lake remains isolated from the glacier surface and atmosphere. This paper presents an electronic control system design of 200 m prototype of RECAS. The proposed electronic control system consists of a surface system, a downhole control system, and a power transfer and communication system. The downhole control system is the core element of RECAS, and is responsible for sonde status monitoring, sonde motion control, subglacial water sampling and in situ analysis. A custom RS485 temperature sensor was developed to cater for the limited size and depth requirements of the system. We adopted a humidity-based measurement to monitor for a housing leak. This condition is because standard leak detection monitoring of water conductivity may be inapplicable to pure ice in Antarctica. A water sampler control board was designed to control the samplers and monitor the on/off state. A high-definition camera system with built-in storage and self-heating ability was designed to perform the video recording in the subglacial lake. The proposed electronic control system is proven effective after a series of tests.
Much progress has been made in understanding the environmental and hormonal systems regulating winter diapause. However, transcriptional regulation of summer diapause is still largely unknown, making it difficult to understand an all-around regulation profile of seasonal adaptation. To bridge this gap, comparison RNA-seq to profile the transcriptome and to examine differential gene expression profiles between non-diapause, summer diapause, and winter diapause groups were performed. A total number of 113 million reads were generated and assembled into 79,117 unigenes, with 37,492 unigenes categorized into 58 functional gene ontology groups, 25 clusters of orthologous group categories, and 256 Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. KEGG analysis mapped 2108 differentially expressed genes to 48 and 67 pathways for summer and winter diapauses, respectively. Enrichment statistics showed that 11 identical pathways similarly overlapped in the top 20 enriched functional groups both related to summer and winter diapauses. We also identified 35 key candidate genes for universal and differential functions related to summer and winter diapause preparation. Furthermore, we identified some genes involved in the signaling and metabolic pathways that may be the key drivers to integrate environmental signals into the summer and winter diapause preparation. The current study provided valuable insights into global molecular mechanisms underpinning diapause preparation.
In a recent communication on carbon isotope chemostratigraphy of the uppermost Cambrian strata, it was claimed that the Top of Cambrian Excursion (TOCE) is (1) an undocumented negative δ13Ccarb excursion; (2) ambiguously defined; (3) deliberately fictitious or, in the authors’ words, a ‘nihilartikel’; and (4) not synonymous with the Hellnmaria–Red Tops Boundary (HERB) Event. As the authors who have been involved in much of the discussion surrounding the TOCE since its introduction and in subsequent clarification, we wish to emphasize that the recent communication overlooks the fact that the TOCE is in fact a well-documented and clearly defined negative δ13Ccarb excursion, and that the term ‘HERB Event’ was originally used informally, without definition or reference data, for a negative δ13Ccarb peak, a peak later shown to occur within the TOCE excursion. Nearly a decade after the TOCE was named, the concept of the HERB Event was modified from a negative δ13Ccarb peak to a negative δ13Ccarb excursion, making it conceptually synonymous with the TOCE excursion. The recently published commentary is misleading and replete with misconceptions, as we discuss here.
A recently developed pneumonia caused by SARS-CoV-2 has quickly spread across the world. Unfortunately, a simplified risk score that could easily be used in primary care or general practice settings has not been developed. The objective of this study is to identify a simplified risk score that could easily be used to quickly triage severe COVID-19 patients. All severe and critical adult patients with laboratory-confirmed COVID-19 on the West campus of Union Hospital, Wuhan, China, from 28 January 2020 to 29 February 2020 were included in this study. Clinical data and laboratory results were obtained. CURB-65 pneumonia score was calculated. Univariate logistic regressions were applied to explore risk factors associated with in-hospital death. We used the receiver operating characteristic curve and multivariate COX-PH model to analyse risk factors for in-hospital death. A total of 74 patients (31 died, 43 survived) were finally included in the study. We observed that compared with survivors, non-survivors were older and illustrated higher respiratory rate, neutrophil-to-lymphocyte ratio, D-dimer and lactate dehydrogenase (LDH), but lower SpO2 as well as impaired liver function, especially synthesis function. CURB-65 showed good performance for predicting in-hospital death (area under curve 0.81, 95% confidence interval (CI) 0.71–0.91). CURB-65 ⩾ 2 may serve as a cut-off value for prediction of in-hospital death in severe patients with COVID-19 (sensitivity 68%, specificity 81%, F1 score 0.7). CURB-65 (hazard ratio (HR) 1.61; 95% CI 1.05–2.46), LDH (HR 1.003; 95% CI 1.001–1.004) and albumin (HR 0.9; 95% CI 0.81–1) were risk factors for in-hospital death in severe patients with COVID-19. Our study indicates CURB-65 may serve as a useful prognostic marker in COVID-19 patients, which could be used to quickly triage severe patients in primary care or general practice settings.