Risk factors for adverse clinical outcomes with COVID-19 in China: a multicenter, retrospective, observational study

Abstract

Background:The risk factors for adverse events of Coronavirus have not been well described. We aimed to explore the predictive value of clinical, laboratory and CT imaging characteristics on admission for short-term outcomes of COVID-19 patients. Methods: This multicenter, retrospective, observation study enrolled 703 laboratory-confirmed COVID-19 patients admitted to 16 tertiary hospitals from 8 provinces in China between January 10, 2020 and March 13, 2020. Demographic, clinical, laboratory data, CT imaging findings on admission and clinical outcomes were collected and compared. The primary endpoint was in-hospital death, the secondary endpoints were composite clinical adverse outcomes including in-hospital death, admission to intensive care unit (ICU) and requiring invasive mechanical ventilation support (IMV). Multivariable Cox regression, Kaplan-Meier plots and log-rank test were used to explore risk factors related to in-hospital death and in-hospital adverse outcomes. Results: Of 703 patients, 55 (8%) developed adverse outcomes (including 33 deceased), 648 (92%) discharged without any adverse outcome. Multivariable regression analysis showed risk factors associated with in-hospital death included ≥ 2 comorbidities (hazard ratio [HR

Development and Validation of a Deep Learning-Based Model Using Computed Tomography Imaging for Predicting Disease Severity of Coronavirus Disease 2019

“…The CT severity score in the first method (Chang et al, 2005) is a semiquantitative index for estimating the involvement of the lung, which is related to the number of involved lobes and the extent of the lesions: the larger the score, the higher the risk of future development of severe COVID-19. The effectiveness of the CT severity score in the early prediction of COVID-19 progression was validated by some COVID-19 studies (Feng et al, 2020;Li et al, 2020b;Xu et al, 2020;Zheng, 2020). In addition, the CT severity score has also been proposed for prognosis and mortality prediction in acute Middle East respiratory syndrome (Das et al, 2015).…”

COVID-19: Progress in diagnostics, therapy and vaccination

“…As the assay uses similar specimen collection and nucleic acid extraction methods as the CDC and other RT-qPCR assays, it is subjected to the same potential limitations with regard to the availability of personal protective equipment, extraction kits and reagents. Therefore, many clinicians have proposed that computed tomography (CT) scans should be a necessary auxiliary diagnostic method 52 - 56 . To identify and quarantine patients at an early date, patients clinically diagnosed by chest CT with typical ground-glass lung opacities were also counted as confirmed cases beginning in early February 57 - 60 .…”

A Prognostic Model for Death in COVID-19 Patients Presenting to the Emergency Room: The Added Value of Computed Tomography.

“…The potential prognostic role of CT-based assessment of lung disease extension has been suggested [13][14][15][16]27], and a few studies have included it in combined prognostic models [17][18][19][20]. Colombi et al found a slightly higher increase in AUC (from 0.83 to 0.86) when adding CT disease extension to a clinical model predictive of intensive care unit admission and/or death [17].…”

“…The few studies that combined clinical, laboratory, and CT ndings in predictive prognostic models [17][18][19][20] showed inconsistent results: some suggested a better performance of the model when adding CT [17], others showed that CT ndings had insu cient prognostic power to be selected in multivariable models [19].…”