Establishment of Routine Clinical Indicators-Based Nomograms for Predicting the Mortality in Patients with COVID-19

Abstract

Background: The aim of the study was to establish and validate nomograms to predict the mortality risk of patients with COVID-19 using routine clinical indicators. Method: This retrospective study included a development cohort enrolled 2119 hospitalized COVID-19 patients and a validation cohort included 1504 COVID-19 patients. The demographics, clinical manifestations, vital signs and laboratory test results of the patients at admission and outcome of in-hospital death were recorded. The independent factors associated with death were identified by a forward stepwise multivariate logistic regression analysis and used to construct two prognostic nomograms. The models were then tested in an external dataset. Results: Nomogram 1 is a full model included nine factors identified in the multivariate logistic regression and nomogram 2 is built by selecting four factors from nine to perform as a reduced model. Nomogram 1 and nomogram 2 established showed better performance in discrimination and calibration than the MuLBSTA score in training. In validation, Nomogram 1 performed better than nomogram 2 for calibration. Conclusion: Nomograms we established performed better than the MuLBSTA score. We recommend the application of nomogram 1 in general hospital which provide robust prognostic performance but more cumbersome; nomogram 2 in mobile cabin hospitals which depend on less laboratory examinations and more convenient. Both nomograms can help clinicians in identifying patients at risk of death with routine clinical indicators at admission, which may reduce the overall mortality of COVID-19.

A relationship between musculoskeletal pain and prognosis in hospitalized COVID-19 patients

“…The most common risk factors for mortality in the prognosis of the COVID-19 are multilobular infiltration in the lungs, lymphopenia, the existence of bacterial coinfection, the history of smoking, hypertension and age parameters (19,20). The existence of myalgia in the early period of the disease with high ALT and high hemoglobin levels was shown as a predictive indicator of severe SARS-CoV-2 infection (21).…”