Development and validation of a laboratory risk score for the early prediction of COVID-19 severity and in-hospital mortality

Bennouar, Salam; Cherif, A. Bachir; Kessira, Amel; Bennouar, Djamel-Eddine; Abdi, Samia

doi:10.1016/j.iccn.2021.103012

Cited by 11 publications

(12 citation statements)

References 33 publications

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“…Studies also included SpO 2 as a predictor [ 24 , 27 , 30 , 37 , 39 ]. The present cutoff value of 90% upon admission was compatible with reported values under 94% [ 24 , 26 , 33 , 37 ]. A number of patients already required supplementary oxygen before admission, thus ambient-air saturation values were not available.…”

Section: Discussionsupporting

confidence: 91%

“…In accordance with our findings, age was identified as a significant predictor across studies [ 23 – 28 , 30 – 37 , 39 ]. If its influence was quantified via cutoff values, these mostly ranged between 60 and 75 years [ 25 , 26 , 30 – 32 , 36 , 37 ] and thus were not markedly different from the value of 70 years which we found adequate for all outcomes. Studies also included SpO 2 as a predictor [ 24 , 27 , 30 , 37 , 39 ].…”

Section: Discussionmentioning

confidence: 67%

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A simple risk score for mortality including the PCR Ct value upon admission in patients hospitalized due to COVID-19

et al. 2022

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Purpose To develop a simple score for the outcomes from COVID-19 that integrates information obtained at the time of admission including the Ct value (cycle threshold) for SARS-CoV-2. Methods Patients with COVID-19 hospitalized from February 1st to May 31st 2021 in RoMed hospitals, Germany, were included. Clinical and laboratory parameters upon admission were recorded and patients followed until discharge or death. Logistic regression analysis was used to determine predictors of outcomes. Regression coefficients were used to develop a risk score for death. Results Of 289 patients (46% female, median age 66 years), 29% underwent high-flow nasal oxygen (HFNO) therapy, 28% were admitted to the Intensive Care Unit (ICU, 51% put on invasive ventilation, IV), and 15% died. Age > 70 years, oxygen saturation ≤ 90%, oxygen supply upon admission, eGFR ≤ 60 ml/min and Ct value ≤ 26 were significant ( p < 0.05 each) predictors for death, to which 2, 2, 1, 1 and 2 score points, respectively, could be attributed. Sum scores of ≥ 4 or ≥ 5 points were associated with a sensitivity of 95.0% or 82.5%, and a specificity of 72.5% or 81.7% regarding death. The high predictive value of the score was confirmed using data obtained between December 15th 2020 and January 31st 2021 ( n = 215). Conclusion In COVID-19 patients, a simple scoring system based on data available shortly after hospital admission including the Ct value had a high predictive value for death. The score may also be useful to estimate the likelihood for required interventions at an early stage. Supplementary Information The online version contains supplementary material available at 10.1007/s15010-022-01783-1.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 67%

A simple risk score for mortality including the PCR Ct value upon admission in patients hospitalized due to COVID-19

et al. 2022

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“…Most studies published to-date have focused on mortality or severe COVID-19, although the findings were similar to those in the current study [36,37,38] [40].…”

Section: Discussionsupporting

confidence: 87%

On-admission laboratory predictors for developing critical COVID-19 during hospitalization – a multivariable logistic regression model

Schmidt¹,

Jóźwiak²,

Czabajska³

et al. 2022

Ann Agric Environ Med.

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Introduction and Objective. Recognition of patients with COVID-19 who will progress clinically and need respiratory support remains challenging. The aim of the study was to identify abnormalities in on-admission laboratory results that can precede progression from moderate or severe to critical COVID-19. Materials and method. Laboratory data analyzed of 190 patients admitted with moderate or severe COVID-19 to our ward. Laboratory results taken into analysis were obtained during the first 48 hours of hospitalization. Multivariate logistic regression was performed using risk factors obtained in the univariate analysis as dependent variables. Results. 42 patients were identified who developed critical COVID-19. In univariate analysis, 22 laboratory risk factors were detected that were used in logistic regression and in building model with following predictors: high-sensitive troponin I concentration (hs-TnI) >26 ng/mL (OR 13.45;

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“…In comparison to other scores (see Additional file 1 : Table S1), our predictive score had at least equivalent or better predictive performance for short term mortality and/or ICU requirement and can be determined quickly after hospital admission, using only two parameters potentially routinely available: IL-6 and CATi alleviating the need for many other expensive biological measurements (see Additional file 1 : Table S1). As an example, Bennouar et al validate a risk score including age and 6 biological variables (blood urea nitrogen, LDH, NLR, CRP, albumin and natremia) combined into an ordinal risk score consisting of seven consecutive levels (S0-S7), survival duration decreasing gradually with increasing risk score levels [ 30 ]. Another score has been developed by Liang et al to predict admission to ICU, invasive ventilation, and death including 10 variables (chest radiographic abnormality, age, hemoptysis, dyspnea, level of consciousness, number of comorbidities, cancer history, neutrophil-to-lymphocyte ratio, lactate dehydrogenase and direct bilirubin) [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiac adipose tissue volume and IL-6 level at admission are complementary predictors of severity and short-term mortality in COVID-19 diabetic patients

Phan

Boussouar

Lucidarme

et al. 2021

Cardiovasc Diabetol

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Background COVID-19 diabetic adults are at increased risk of severe forms irrespective of obesity. In patients with type-II diabetes, fat distribution is characterized by visceral and ectopic adipose tissues expansion, resulting in systemic inflammation, which may play a role in driving the COVID-19 cytokine storm. Our aim was to determine if cardiac adipose tissue, combined to interleukin-6 levels, could predict adverse short-term outcomes, death and ICU requirement, in COVID-19 diabetic patients during the 21 days after admission. Methods Eighty one consecutive patients with type-II diabetes admitted for COVID-19 were included. Interleukin-6 measurement and chest computed tomography with total cardiac adipose tissue index (CATi) measurement were performed at admission. The primary outcome was death during the 21 days following admission while intensive care requirement with or without early death (ICU-R) defined the secondary endpoint. Associations of CATi and IL-6 and threshold values to predict the primary and secondary endpoints were determined. Results Of the enrolled patients (median age 66 years [IQR: 59–74]), 73% male, median body mass index (BMI) 27 kg/m2 [IQR: 24–31]) 20 patients had died from COVID-19, 20 required intensive care and 41 were in conventional care at day 21 after admission. Increased CATi and IL-6 levels were both significantly related to increased early mortality (respectively OR = 6.15, p = 0.002; OR = 18.2, p < 0.0001) and ICU-R (respectively OR = 3.27, p = 0.01; OR = 4.86, p = 0.002). These associations remained significant independently of age, sex, BMI as well as troponin-T level and pulmonary lesion extension in CT. We combined CATi and IL-6 levels as a multiplicative interaction score (CATi*IL-6). The cut-point for this score was ≥ 6386 with a sensitivity of 0.90 and a specificity of 0.87 (AUC = 0.88) and an OR of 59.6 for early mortality (p < 0.0001). Conclusions Cardiac adipose tissue index and IL-6 determination at admission could help physicians to better identify diabetic patients with a potentially severe and lethal short term course irrespective of obesity. Diabetic patients with high CATi at admission, a fortiori associated with high IL-6 levels could be a relevant target population to promptly initiate anti-inflammatory therapies.

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Development and validation of a laboratory risk score for the early prediction of COVID-19 severity and in-hospital mortality

Cited by 11 publications

References 33 publications

A simple risk score for mortality including the PCR Ct value upon admission in patients hospitalized due to COVID-19

A simple risk score for mortality including the PCR Ct value upon admission in patients hospitalized due to COVID-19

On-admission laboratory predictors for developing critical COVID-19 during hospitalization – a multivariable logistic regression model

Cardiac adipose tissue volume and IL-6 level at admission are complementary predictors of severity and short-term mortality in COVID-19 diabetic patients

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