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Early prediction and identification for severe patients during the pandemic of COVID-19: A severe COVID-19 risk model constructed by multivariate logistic regression analysis

BACKGROUND: As an emergent and fulminant infectious disease, Corona Virus Disease 2019 (COVID-19) has caused a worldwide pandemic. The early identification and timely treatment of severe patients are crucial to reducing the mortality of COVID-19. This study aimed to investigate the clinical characte...

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Autores principales: Hu, Haifeng, Du, Hong, Li, Jing, Wang, Yage, Wu, Xiaoqing, Wang, Chunfu, Zhang, Ye, Zhang, Gufen, Zhao, Yanyan, Kang, Wen, Lian, Jianqi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Society of Global Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567445/
https://www.ncbi.nlm.nih.gov/pubmed/33110593
http://dx.doi.org/10.7189/jogh.10.020510
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author Hu, Haifeng
Du, Hong
Li, Jing
Wang, Yage
Wu, Xiaoqing
Wang, Chunfu
Zhang, Ye
Zhang, Gufen
Zhao, Yanyan
Kang, Wen
Lian, Jianqi
author_facet Hu, Haifeng
Du, Hong
Li, Jing
Wang, Yage
Wu, Xiaoqing
Wang, Chunfu
Zhang, Ye
Zhang, Gufen
Zhao, Yanyan
Kang, Wen
Lian, Jianqi
author_sort Hu, Haifeng
collection PubMed
description BACKGROUND: As an emergent and fulminant infectious disease, Corona Virus Disease 2019 (COVID-19) has caused a worldwide pandemic. The early identification and timely treatment of severe patients are crucial to reducing the mortality of COVID-19. This study aimed to investigate the clinical characteristics and early predictors for severe COVID-19, and to establish a prediction model for the identification and triage of severe patients. METHODS: All confirmed patients with COVID-19 admitted by the Second Affiliated Hospital of Air Force Medical University were enrolled in this retrospective non-interventional study. The patients were divided into a mild group and a severe group, and the clinical data were compared between the two groups. Univariate and multivariate analysis were used to identify the independent early predictors for severe COVID-19, and the prediction model was constructed by multivariate logistic regression analysis. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the prediction model and each early predictor. RESULTS: A total of 40 patients were enrolled in this study, of whom 19 were mild and 21 were severe. The proportions of patients with venerable age (≥60 years old), comorbidities, and hypertension in severe patients were higher than that of the mild (P < 0.05). The duration of fever and respiratory symptoms, and the interval from illness onset to viral clearance were longer in severe patients (P < 0.05). Most patients received at least one form of oxygen treatments, while severe patients required more mechanical ventilation (P < 0.05). Univariate and multivariate analysis showed that venerable age, hypertension, lymphopenia, hypoalbuminemia and elevated neutrophil lymphocyte ratio (NLR) were the independent high-risk factors for severe COVID-19. ROC curves demonstrated significant predictive value of age, lymphocyte count, albumin and NLR for severe COVID-19. The sensitivity and specificity of the newly constructed prediction model for predicting severe COVID-19 was 90.5% and 84.2%, respectively, and whose positive predictive value, negative predictive value and crude agreement were all over 85%. CONCLUSIONS: The severe COVID-19 risk model might help clinicians quickly identify severe patients at an early stage and timely take optimal therapeutic schedule for them.
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spelling pubmed-75674452020-10-21 Early prediction and identification for severe patients during the pandemic of COVID-19: A severe COVID-19 risk model constructed by multivariate logistic regression analysis Hu, Haifeng Du, Hong Li, Jing Wang, Yage Wu, Xiaoqing Wang, Chunfu Zhang, Ye Zhang, Gufen Zhao, Yanyan Kang, Wen Lian, Jianqi J Glob Health Research Theme 1: COVID-19 Pandemic BACKGROUND: As an emergent and fulminant infectious disease, Corona Virus Disease 2019 (COVID-19) has caused a worldwide pandemic. The early identification and timely treatment of severe patients are crucial to reducing the mortality of COVID-19. This study aimed to investigate the clinical characteristics and early predictors for severe COVID-19, and to establish a prediction model for the identification and triage of severe patients. METHODS: All confirmed patients with COVID-19 admitted by the Second Affiliated Hospital of Air Force Medical University were enrolled in this retrospective non-interventional study. The patients were divided into a mild group and a severe group, and the clinical data were compared between the two groups. Univariate and multivariate analysis were used to identify the independent early predictors for severe COVID-19, and the prediction model was constructed by multivariate logistic regression analysis. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the prediction model and each early predictor. RESULTS: A total of 40 patients were enrolled in this study, of whom 19 were mild and 21 were severe. The proportions of patients with venerable age (≥60 years old), comorbidities, and hypertension in severe patients were higher than that of the mild (P < 0.05). The duration of fever and respiratory symptoms, and the interval from illness onset to viral clearance were longer in severe patients (P < 0.05). Most patients received at least one form of oxygen treatments, while severe patients required more mechanical ventilation (P < 0.05). Univariate and multivariate analysis showed that venerable age, hypertension, lymphopenia, hypoalbuminemia and elevated neutrophil lymphocyte ratio (NLR) were the independent high-risk factors for severe COVID-19. ROC curves demonstrated significant predictive value of age, lymphocyte count, albumin and NLR for severe COVID-19. The sensitivity and specificity of the newly constructed prediction model for predicting severe COVID-19 was 90.5% and 84.2%, respectively, and whose positive predictive value, negative predictive value and crude agreement were all over 85%. CONCLUSIONS: The severe COVID-19 risk model might help clinicians quickly identify severe patients at an early stage and timely take optimal therapeutic schedule for them. International Society of Global Health 2020-12 2020-09-04 /pmc/articles/PMC7567445/ /pubmed/33110593 http://dx.doi.org/10.7189/jogh.10.020510 Text en Copyright © 2020 by the Journal of Global Health. All rights reserved. http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License.
spellingShingle Research Theme 1: COVID-19 Pandemic
Hu, Haifeng
Du, Hong
Li, Jing
Wang, Yage
Wu, Xiaoqing
Wang, Chunfu
Zhang, Ye
Zhang, Gufen
Zhao, Yanyan
Kang, Wen
Lian, Jianqi
Early prediction and identification for severe patients during the pandemic of COVID-19: A severe COVID-19 risk model constructed by multivariate logistic regression analysis
title Early prediction and identification for severe patients during the pandemic of COVID-19: A severe COVID-19 risk model constructed by multivariate logistic regression analysis
title_full Early prediction and identification for severe patients during the pandemic of COVID-19: A severe COVID-19 risk model constructed by multivariate logistic regression analysis
title_fullStr Early prediction and identification for severe patients during the pandemic of COVID-19: A severe COVID-19 risk model constructed by multivariate logistic regression analysis
title_full_unstemmed Early prediction and identification for severe patients during the pandemic of COVID-19: A severe COVID-19 risk model constructed by multivariate logistic regression analysis
title_short Early prediction and identification for severe patients during the pandemic of COVID-19: A severe COVID-19 risk model constructed by multivariate logistic regression analysis
title_sort early prediction and identification for severe patients during the pandemic of covid-19: a severe covid-19 risk model constructed by multivariate logistic regression analysis
topic Research Theme 1: COVID-19 Pandemic
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567445/
https://www.ncbi.nlm.nih.gov/pubmed/33110593
http://dx.doi.org/10.7189/jogh.10.020510
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