tetano
Editor, Senior Moderator
J Clin Lab Anal
. 2021 Dec 23;e24177.
doi: 10.1002/jcla.24177. Online ahead of print.
Early predictors of severe COVID-19 among hospitalized patients
Qiongrui Zhao[SUP] 1 [/SUP], Youhua Yuan[SUP] 2 [/SUP], Jiangfeng Zhang[SUP] 3 [/SUP], Jieren Li[SUP] 3 [/SUP], Wei Li[SUP] 4 [/SUP], Kunshan Guo[SUP] 5 [/SUP], Yanchao Wang[SUP] 6 [/SUP], Juhua Chen[SUP] 7 [/SUP], Wenjuan Yan[SUP] 2 [/SUP], Baoya Wang[SUP] 2 [/SUP], Nan Jing[SUP] 2 [/SUP], Bing Ma[SUP] 2 [/SUP], Qi Zhang[SUP] 2 [/SUP]
Affiliations
Abstract
Background: Limited research has been conducted on early laboratory biomarkers to identify patients with severe coronavirus disease (COVID-19). This study fills this gap to ensure appropriate treatment delivery and optimal resource utilization.
Methods: In this retrospective, multicentre, cohort study, 52 and 64 participants with severe and mild cases of COVID-19, respectively, were enrolled during January-March 2020. Least absolute shrinkage and selection operator and binary forward stepwise logistic regression were used to construct a predictive risk score. A prediction model was then developed and verified using data from four hospitals.
Results: Of the 50 variables assessed, eight were independent predictors of COVID-19 and used to calculate risk scores for severe COVID-19: age (odds ratio (OR = 14.01, 95% confidence interval (CI) 2.1-22.7), number of comorbidities (OR = 7.8, 95% CI 1.4-15.5), abnormal bilateral chest computed tomography images (OR = 8.5, 95% CI 4.5-10), neutrophil count (OR = 10.1, 95% CI 1.88-21.1), lactate dehydrogenase (OR = 4.6, 95% CI 1.2-19.2), C-reactive protein OR = 16.7, 95% CI 2.9-18.9), haemoglobin (OR = 16.8, 95% CI 2.4-19.1) and D-dimer levels (OR = 5.2, 95% CI 1.2-23.1). The model was effective, with an area under the receiver-operating characteristic curve of 0.944 (95% CI 0.89-0.99, p < 0.001) in the derived cohort and 0.8152 (95% CI 0.803-0.97; p < 0.001) in the validation cohort.
Conclusion: Predictors based on the characteristics of patients with COVID-19 at hospital admission may help predict the risk of subsequent critical illness.
Keywords: COVID-19; cohort study; prediction model; predictor.
. 2021 Dec 23;e24177.
doi: 10.1002/jcla.24177. Online ahead of print.
Early predictors of severe COVID-19 among hospitalized patients
Qiongrui Zhao[SUP] 1 [/SUP], Youhua Yuan[SUP] 2 [/SUP], Jiangfeng Zhang[SUP] 3 [/SUP], Jieren Li[SUP] 3 [/SUP], Wei Li[SUP] 4 [/SUP], Kunshan Guo[SUP] 5 [/SUP], Yanchao Wang[SUP] 6 [/SUP], Juhua Chen[SUP] 7 [/SUP], Wenjuan Yan[SUP] 2 [/SUP], Baoya Wang[SUP] 2 [/SUP], Nan Jing[SUP] 2 [/SUP], Bing Ma[SUP] 2 [/SUP], Qi Zhang[SUP] 2 [/SUP]
Affiliations
- PMID: 34951061
- DOI: 10.1002/jcla.24177
Abstract
Background: Limited research has been conducted on early laboratory biomarkers to identify patients with severe coronavirus disease (COVID-19). This study fills this gap to ensure appropriate treatment delivery and optimal resource utilization.
Methods: In this retrospective, multicentre, cohort study, 52 and 64 participants with severe and mild cases of COVID-19, respectively, were enrolled during January-March 2020. Least absolute shrinkage and selection operator and binary forward stepwise logistic regression were used to construct a predictive risk score. A prediction model was then developed and verified using data from four hospitals.
Results: Of the 50 variables assessed, eight were independent predictors of COVID-19 and used to calculate risk scores for severe COVID-19: age (odds ratio (OR = 14.01, 95% confidence interval (CI) 2.1-22.7), number of comorbidities (OR = 7.8, 95% CI 1.4-15.5), abnormal bilateral chest computed tomography images (OR = 8.5, 95% CI 4.5-10), neutrophil count (OR = 10.1, 95% CI 1.88-21.1), lactate dehydrogenase (OR = 4.6, 95% CI 1.2-19.2), C-reactive protein OR = 16.7, 95% CI 2.9-18.9), haemoglobin (OR = 16.8, 95% CI 2.4-19.1) and D-dimer levels (OR = 5.2, 95% CI 1.2-23.1). The model was effective, with an area under the receiver-operating characteristic curve of 0.944 (95% CI 0.89-0.99, p < 0.001) in the derived cohort and 0.8152 (95% CI 0.803-0.97; p < 0.001) in the validation cohort.
Conclusion: Predictors based on the characteristics of patients with COVID-19 at hospital admission may help predict the risk of subsequent critical illness.
Keywords: COVID-19; cohort study; prediction model; predictor.