Sequential Organ Failure Assessment (SOFA) score and quick SOFA(qSOFA) predict 30-day mortality in patients with HIV-associated Talaromycosis: A multicenter retrospective cohort study.

HIV-associated talaromycosis (HAT) is a severe fungal infection for which established severity assessment methods are lacking. The Sequential Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) scores were evaluated in 464 patients with HAT to assess their associations with inflammatory markers, hospital stay, and 30-day mortality. SOFA scores were negatively correlated with blood culture positivity time (r = -0.470, P < 0.001) and positively correlated with IL-6, IL-10, and CRP (all P < 0.001). Patients with fungemia had higher SOFA scores (2.3 ± 2.4 vs. 1.2 ± 0.6, P < 0.001). Mortality increased with qSOFA scores: 8.9% (score 0), 16.5% (score 1), and 55.0% (score ≥2; P < 0.001). For SOFA, mortality was 4.5% (scores 0-1), 6.8% (2-3), 22.0% (4-5), 52.2% (6-7), and 85.7% (≥8; P < 0.001), repectively. Survivors' SOFA scores improved by day 7 (1.6 ± 1.6 to 1.0 ± 1.4, P < 0.001), while non-survivors worsened by day 7 (4.8 ± 3.4 to 5.1 ± 5.6, P = 0.027) compared to day 0. Among the surviving patients, the hospital stay days were 21.0 (14.0-27.0) for scores 0-1, 22.0 (16.0-29.0) for scores 2-3, 27.0 (20.3-43.5) for scores 4-6 and 29.0 (5.5-38.0) for scores ≥6 (P = 0.005). Multivariate analysis identified qSOFA [adjusted odds ratio (AOR):1.564, P = 0.018], SOFA [AOR:1.533, P = 0.001], and non-amphotericin B deoxycholate (non-AmBd) therapy [AOR:2.732, P = 0.026] were independent predictors of 30-day mortality. SOFA and qSOFA both predicted poor outcomes in patients with HAT. Early diagnosis and preemptive AmBd therapy should be prioritized for patients with HAT who had high SOFA/qSOFA scores.