COVID-MATCH65 – A prospectively derived clinical decision rule for severe acute respiratory syndrome coronavirus 2

Trubiano, Jason A; Vogrin, Sara; Smibert, Olivia C; Marhoon, Nada; Alexander, Adrian A; Chua, Kyra; James, Fiona; Jones, N.; Grigg, Sam; Xu, Cecilia L H; Moini, Nasreen; Stanley, Sam R; Birrell, Michael T; Rose, Morgan; Gordon, Claire L.; Kwong, Jason C; Holmes, Natasha E

doi:10.1101/2020.06.30.20143818

Cited by 8 publications

(7 citation statements)

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“…In the UK Biobank cohort [33], former (RR = 1.29, 95% CI = 1.14–1.45, P < 0.001) and current (RR = 1.44, 95% CI = 1.20–1.71, P < 0.001) compared with never smokers were more likely to receive a test in a multivariable analysis. In an Australian rapid assessment screening clinic for COVID‐19 [34], 9.4% (397 of 4226) of the self‐referred sample (subsequently assessed by a health‐care professional to decide on testing) were current smokers. Current compared with former or never smokers were less likely to require a test (RR = 0.93, 95% CI = 0.86–1.0, P = 0.045).…”

Section: Resultsmentioning

confidence: 99%

The association of smoking status with SARS‐CoV‐2 infection, hospitalization and mortality from COVID‐19: a living rapid evidence review with Bayesian meta‐analyses (version 7)

et al. 2020

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Aims To estimate the association of smoking status with rates of i) infection, ii) hospitalisation, iii) disease severity, and iv) mortality from SARS‐CoV‐2/COVID‐19 disease. Design Living rapid review of observational and experimental studies with random‐effects hierarchical Bayesian meta‐analyses. Published articles and pre‐prints were identified via MEDLINE and medRxiv. Setting Community or hospital. No restrictions on location. Participants Adults who received a SARS‐CoV‐2 test or a COVID‐19 diagnosis. Measurements Outcomes were SARS‐CoV‐2 infection, hospitalisation, disease severity and mortality stratified by smoking status. Study quality was assessed (i.e. ‘good’, ‘fair’ and ‘poor’). Findings Version 7 (searches up to 25 August 2020) included 233 studies with 32 ‘good’ and ‘fair’ quality studies included in meta‐analyses. Fifty‐seven studies (24.5%) reported current, former and never smoking status. Recorded smoking prevalence among people with COVID‐19 was generally lower than national prevalence. Current compared with never smokers were at reduced risk of SARS‐CoV‐2 infection (RR=0.74, 95% Credible Interval (CrI) = 0.58‐0.93, τ = 0.41). Data for former smokers were inconclusive (RR=1.05, 95% CrI = 0.95‐1.17, τ = 0.17) but favoured there being no important association (21% probability of RR ≥1.1). Former compared with never smokers were at somewhat increased risk of hospitalisation (RR=1.20, CrI = 1.03‐1.44, τ = 0.17), greater disease severity (RR=1.52, CrI = 1.13‐2.07, τ = 0.29), and mortality (RR=1.39, 95% CrI = 1.09‐1.87, τ = 0.27). Data for current smokers were inconclusive (RR=1.06, CrI = 0.82‐1.35, τ = 0.27; RR=1.25, CrI = 0.85‐1.93, τ = 0.34; RR=1.22, 95% CrI = 0.78‐1.94, τ = 0.49 respectively) but favoured there being no important associations with hospitalisation and mortality (35% and 70% probability of RR ≥1.1, respectively) and a small but important association with disease severity (79% probability of RR ≥1.1). Conclusions Compared with never smokers, current smokers appear to be at reduced risk of SARS‐CoV‐2 infection while former smokers appear to be at increased risk of hospitalisation, increased disease severity and mortality from COVID‐19. However, it is uncertain whether these associations are causal.

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Section: Resultsmentioning

confidence: 99%

The association of smoking status with SARS‐CoV‐2 infection, hospitalization and mortality from COVID‐19: a living rapid evidence review with Bayesian meta‐analyses (version 7)

et al. 2020

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“… Φ COVID-MATCH65 Score is a clinical decision rule internally derived that has a high sensitivity (92.6%) and NPV (99.5%) for SARS-CoV-2 and can be used to aid COVID-19 risk assessment and resource allocation for SARS-CoV-2 diagnostics. The resulting score ranges from 1 to 6.5 points with score ≤ 1 representing low risk for a positive test ( 9 ). ▽ Time from symptoms presentation and study recruitment (days).…”

Section: Resultsmentioning

confidence: 99%

The Role of Immunological and Clinical Biomarkers to Predict Clinical COVID-19 Severity and Response to Therapy—A Prospective Longitudinal Study

et al. 2021

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BackgroundThe association of pro-inflammatory markers such as interleukin-6 (IL-6) and other biomarkers with severe coronavirus disease 2019 (COVID-19) is of increasing interest, however their kinetics, response to current COVID-related treatments, association with disease severity and comparison with other disease states associated with potential cytokine storm (CS) such as Staphylococcus aureus bacteraemia (SAB) are ill-defined.MethodsA cohort of 55 hospitalized SARS-CoV-2 positive patients was prospectively recruited – blood sampling was performed at baseline, post-treatment and hospital discharge. Serum IL-6, C-reactive protein (CRP) and other laboratory investigations were compared between treatment groups and across timepoints. Acute serum IL-6 and CRP levels were then compared to those with suspected COVID-19 (SCOVID) and age and sex matched patients with SAB and patients hospitalized for any non-infectious condition (NIC).ResultsIL-6 was elevated at admission in the SARS-CoV-2 cohort but at lower levels compared to matched SAB patients. Median (IQR) IL-6 at admission was 73.89 pg/mL (30.9, 126.39) in SARS-CoV-2 compared to 92.76 pg/mL (21.75, 246.55) in SAB (p=0.017); 12.50 pg/mL (3.06, 35.77) in patients with NIC; and 95.51 pg/mL (52.17, 756.67) in SCOVID. Median IL-6 and CRP levels decreased between admission and discharge timepoints. This reduction was amplified in patients treated with remdesivir and/or dexamethasone. CRP and bedside vital signs were the strongest predictors of COVID-19 severity.ConclusionsKnowledge of the kinetics of IL-6 did not offer enhanced predictive value for disease severity in COVID-19 over common investigations such as CRP and vital signs.

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“…In the UK Biobank cohort34 , a multivariable analysis showed former (RR = 1.29, 95% CI = 1.14-1.45, p < .001) and current (RR = 1.44, 95% CI = 1.20-1.71, p < .001) compared with never smokers to be more likely to receive a test. In an Australian rapid assessment screening clinic for COVID-1935 , 9.4% (397/4,226) of the self-referred sample (subsequently assessed by a healthcare professional to decide on testing) were current smokers. Of…”

mentioning

confidence: 99%

The association of smoking status with SARS-CoV-2 infection, hospitalisation and mortality from COVID-19: A living rapid evidence review with Bayesian meta-analyses (version 10)

Simons

Shahab

Brown

et al. 2021

Preprint

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Aims: To estimate the association of smoking status with rates of i) infection, ii) hospitalisation, iii) disease severity, and iv) mortality from SARS-CoV-2/COVID-19 disease.Design: Living rapid review of observational and experimental studies with random-effects hierarchical Bayesian metaanalyses. Published articles and pre-prints were identified via MEDLINE and medRxiv.Setting: Community or hospital. No restrictions on location.Participants: Adults who received a SARS-CoV-2 test or a COVID-19 diagnosis.Measurements: Outcomes were SARS-CoV-2 infection, hospitalisation, disease severity and mortality stratified by smoking status. Study quality was assessed (i.e. 'good', 'fair' and 'poor').Findings: Version 10 (searches up to 15 December 2020) included 345 studies with 52 'good' and 'fair' quality studies included in unadjusted meta-analyses. One-hundred-and-one studies (29.3%) reported current, former and never smoking status with the remainder using broader categories. Recorded smoking prevalence among people with COVID-19 was generally lower than national prevalence. Current compared with never smokers were at reduced risk of SARS-CoV-2 infection (RR = 0.69, 95% Credible Interval (CrI) = 0.58-0.82, τ = 0.36). Data for former smokers were inconclusive (RR = 1.03, 95% CrI = 0.94-1.13, τ = 0.18) but favoured there being no important association (8% probability of RR ≥1.1). Former compared with never smokers were at increased risk of hospitalisation (

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COVID-MATCH65 – A prospectively derived clinical decision rule for severe acute respiratory syndrome coronavirus 2

Cited by 8 publications

References 12 publications

The association of smoking status with SARS‐CoV‐2 infection, hospitalization and mortality from COVID‐19: a living rapid evidence review with Bayesian meta‐analyses (version 7)

The association of smoking status with SARS‐CoV‐2 infection, hospitalization and mortality from COVID‐19: a living rapid evidence review with Bayesian meta‐analyses (version 7)

The Role of Immunological and Clinical Biomarkers to Predict Clinical COVID-19 Severity and Response to Therapy—A Prospective Longitudinal Study

The association of smoking status with SARS-CoV-2 infection, hospitalisation and mortality from COVID-19: A living rapid evidence review with Bayesian meta-analyses (version 10)

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