Word count: 2973All rights reserved. No reuse allowed without permission.was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. Key points:Question How do nomograms and machine-learning algorithms of severity risk prediction and triage of COVID- patients at hospital admission perform?Findings This model was prospectively validated on six test datasets comprising of 426 patients and yielded AUCs ranging from 0.816 to 0.976, accuracies ranging from 70.8% to 93.8%, sensitivities ranging from 83.7% to 100%, and specificities ranging from 41.0% to 95.7%. The cut-off probability values for low, medium, and high-risk groups were 0.072 and 0.244.Meaning The findings of this study suggest that our models performs well for the diagnosis and prediction of progression to severe or critical illness of COVID-19 patients and could be used for triage of COVID-19 patients at hospital admission.All rights reserved. No reuse allowed without permission.was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
Background The Coronavirus Disease 2019 (COVID-19) pandemic is a world-wide health crisis. Limited information is available regarding which patients will experience more severe disease symptoms. We evaluated hospitalized patients who were initially diagnosed with moderate COVID-19 for clinical parameters and radiological feature that showed an association with progression to severe/critical symptoms. Methods This study, a retrospective single-center study at the Central Hospital of Wuhan, enrolled 243 patients with confirmed COVID19 pneumonia. Forty of these patients progressed from moderate to severe/critical symptoms during follow up. Demographic, clinical, laboratory, and radiological data were extracted from electronic medical records and compared between moderate- and severe/critical-type symptoms. Univariable and multivariable logistic regressions were used to identify the risk factors associated with symptom progression. Results Patients with severe/critical symptoms were older (p < 0.001) and more often male (p = 0.046). A combination of chronic obstructive pulmonary disease (COPD) and high maximum chest computed tomography (CT) score was associated with disease progression. Maximum CT score (> 11) had the greatest predictive value for disease progression. The area under the receiver operating characteristic curve was 0.861 (95% confidence interval: 0.811–0.902). Conclusions Maximum CT score and COPD were associated with patient deterioration. Maximum CT score (> 11) was associated with severe illness.
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