Predictive criteria of severe cases in COVID-19 patients of early stage

Gao, Jinrui; Huang, Xiaofeng; Gu, Haibo; Lou, Lingyun; Xu, Zhihao

doi:10.21203/rs.3.rs-39161/v1

2020

DOI: 10.21203/rs.3.rs-39161/v1

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Predictive criteria of severe cases in COVID-19 patients of early stage

Jinrui Gao

Xiaofeng Huang

Haibo Gu

et al.

Abstract: Abstract Background: Patients with coronavirus disease 2019 (COVID-19) often suffer sudden deterioration of disease around 1 to 2 weeks after onset. Once the disease progressed to severe phase, clinical prognosis of patients will significantly deteriorate.Methods: This was a multicenter retrospective study on patients of all adult inpatients (≥18 years old) from Tianyou Hospital (Wuhan, China) and the Fourth Affiliated Hospi… Show more

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References 9 publications

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A simple and readily available inflammation-based risk scoring system on admission predicts the need for mechanical ventilation in patients with COVID-19

et al. 2021

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Objective To investigate whether a simplified inflammation-based risk scoring system comprising three readily available biomarkers (albumin, C-reactive protein, and leukocytes) may predict major adverse outcomes in patients with COVID-19. Methods Upon admission to the emergency room, the inflammation-based risk scoring system was applied and patients were classified as having mild, moderate, or severe inflammation. In-hospital occurrence of thrombosis, need for mechanical ventilation, and death were recorded. Results One-hundred patients (55 ± 13 years; 71% men) were included and classified as having mild (29%), moderate (12%), or severe (59%) inflammation. The need for mechanical ventilation differed among patients in each group (16%, 50%, and 71%, respectively; P < 0.0001), yielding a 4.1-fold increased risk of requiring mechanical ventilation in patients with moderate inflammation and 5.4 for those with severe inflammation. On the contrary, there were no differences for the occurrence of thrombosis (10%, 8%, and 22%, respectively; P = 0.142) or death (21%, 42%, and 39%, respectively; P = 0.106). In the multivariate analysis, only severe inflammation (hazard ratio [HR] = 4.1), D-dimer > 574 ng/mL (HR = 3.0), and troponin I ≥ 6.7 ng/mL (HR = 2.4) at hospital admission were independent predictors of the need for mechanical ventilation. Conclusion The inflammation-based risk scoring system predicts the need for mechanical ventilation in patients with severe COVID-19.

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A simple and readily available inflammation-based risk scoring system on admission predicts the need for mechanical ventilation in patients with COVID-19

et al. 2021

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A new screening tool for SARS-CoV-2 infection based on self-reported patient clinical characteristics: the COV19-ID score

et al. 2022

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Background While several studies aimed to identify risk factors for severe COVID-19 cases to better anticipate intensive care unit admissions, very few have been conducted on self-reported patient symptoms and characteristics, predictive of RT-PCR test positivity. We therefore aimed to identify those predictive factors and construct a predictive score for the screening of patients at admission. Methods This was a monocentric retrospective analysis of clinical data from 9081 patients tested for SARS-CoV-2 infection from August 1 to November 30 2020. A multivariable logistic regression using least absolute shrinkage and selection operator (LASSO) was performed on a training dataset (60% of the data) to determine associations between self-reported patient characteristics and COVID-19 diagnosis. Regression coefficients were used to construct the Coronavirus 2019 Identification score (COV19-ID) and the optimal threshold calculated on the validation dataset (20%). Its predictive performance was finally evaluated on a test dataset (20%). Results A total of 2084 (22.9%) patients were tested positive to SARS-CoV-2 infection. Using the LASSO model, COVID-19 was independently associated with loss of smell (Odds Ratio, 6.4), fever (OR, 2.7), history of contact with an infected person (OR, 1.7), loss of taste (OR, 1.5), muscle stiffness (OR, 1.5), cough (OR, 1.5), back pain (OR, 1.4), loss of appetite (OR, 1.3), as well as male sex (OR, 1.05). Conversely, COVID-19 was less likely associated with smoking (OR, 0.5), sore throat (OR, 0.9) and ear pain (OR, 0.9). All aforementioned variables were included in the COV19-ID score, which demonstrated on the test dataset an area under the receiver-operating characteristic curve of 82.9% (95% CI 80.6%–84.9%), and an accuracy of 74.2% (95% CI 74.1%–74.3%) with a high sensitivity (80.4%, 95% CI [80.3%–80.6%]) and specificity (72.2%, 95% CI [72.2%–72.4%]). Conclusions The COV19-ID score could be useful in early triage of patients needing RT-PCR testing thus alleviating the burden on laboratories, emergency rooms, and wards.

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Predictive criteria of severe cases in COVID-19 patients of early stage

Cited by 2 publications

References 9 publications

A simple and readily available inflammation-based risk scoring system on admission predicts the need for mechanical ventilation in patients with COVID-19

A simple and readily available inflammation-based risk scoring system on admission predicts the need for mechanical ventilation in patients with COVID-19

A new screening tool for SARS-CoV-2 infection based on self-reported patient clinical characteristics: the COV19-ID score

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