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Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score

This monocentric, retrospective, two-stage observational study aimed to recognize the risk factors for a poor outcome in patients hospitalized with SARS-CoV-2 infection, and to develop and validate a risk score that identifies subjects at risk of worsening, death, or both. The data of patients with...

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Autores principales: Cruciata, Alessia, Volpicelli, Lorenzo, Di Bari, Silvia, Iaiani, Giancarlo, Cirillo, Bruno, Pugliese, Francesco, Pellegrino, Daniela, Galardo, Gioacchino, Taliani, Gloria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8951891/
https://www.ncbi.nlm.nih.gov/pubmed/35337049
http://dx.doi.org/10.3390/v14030642
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author Cruciata, Alessia
Volpicelli, Lorenzo
Di Bari, Silvia
Iaiani, Giancarlo
Cirillo, Bruno
Pugliese, Francesco
Pellegrino, Daniela
Galardo, Gioacchino
Taliani, Gloria
author_facet Cruciata, Alessia
Volpicelli, Lorenzo
Di Bari, Silvia
Iaiani, Giancarlo
Cirillo, Bruno
Pugliese, Francesco
Pellegrino, Daniela
Galardo, Gioacchino
Taliani, Gloria
author_sort Cruciata, Alessia
collection PubMed
description This monocentric, retrospective, two-stage observational study aimed to recognize the risk factors for a poor outcome in patients hospitalized with SARS-CoV-2 infection, and to develop and validate a risk score that identifies subjects at risk of worsening, death, or both. The data of patients with SARS-CoV-2 infection during the first wave of the pandemic were collected and analyzed as a derivation cohort. Variables with predictive properties were used to construct a prognostic score, which was tried out on a validation cohort enrolled during the second wave. The derivation cohort included 494 patients; the median age was 62 and the overall fatality rate was 22.3%. In a multivariable analysis, age, oxygen saturation, neutrophil-to-lymphocyte ratio, C-reactive protein and lactate dehydrogenase were independent predictors of death and composed the score. A cutoff value of 3 demonstrated a sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of 93.5%, 68.5%, 47.4% and 97.2% for death, and 84.9%, 84.5%, 79.6% and 87.9% for worsening, respectively. The validation cohort included 415 subjects. The score application showed a Se, Sp, PPV and NPV of 93.4%, 61.6%, 29.5% and 98.1% for death, and 81%, 76.3%, 72.1% and 84.1% for worsening, respectively. We propose a new clinical, easy and reliable score to predict the outcome in hospitalized SARS-CoV-2 patients.
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spelling pubmed-89518912022-03-26 Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score Cruciata, Alessia Volpicelli, Lorenzo Di Bari, Silvia Iaiani, Giancarlo Cirillo, Bruno Pugliese, Francesco Pellegrino, Daniela Galardo, Gioacchino Taliani, Gloria Viruses Article This monocentric, retrospective, two-stage observational study aimed to recognize the risk factors for a poor outcome in patients hospitalized with SARS-CoV-2 infection, and to develop and validate a risk score that identifies subjects at risk of worsening, death, or both. The data of patients with SARS-CoV-2 infection during the first wave of the pandemic were collected and analyzed as a derivation cohort. Variables with predictive properties were used to construct a prognostic score, which was tried out on a validation cohort enrolled during the second wave. The derivation cohort included 494 patients; the median age was 62 and the overall fatality rate was 22.3%. In a multivariable analysis, age, oxygen saturation, neutrophil-to-lymphocyte ratio, C-reactive protein and lactate dehydrogenase were independent predictors of death and composed the score. A cutoff value of 3 demonstrated a sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of 93.5%, 68.5%, 47.4% and 97.2% for death, and 84.9%, 84.5%, 79.6% and 87.9% for worsening, respectively. The validation cohort included 415 subjects. The score application showed a Se, Sp, PPV and NPV of 93.4%, 61.6%, 29.5% and 98.1% for death, and 81%, 76.3%, 72.1% and 84.1% for worsening, respectively. We propose a new clinical, easy and reliable score to predict the outcome in hospitalized SARS-CoV-2 patients. MDPI 2022-03-20 /pmc/articles/PMC8951891/ /pubmed/35337049 http://dx.doi.org/10.3390/v14030642 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cruciata, Alessia
Volpicelli, Lorenzo
Di Bari, Silvia
Iaiani, Giancarlo
Cirillo, Bruno
Pugliese, Francesco
Pellegrino, Daniela
Galardo, Gioacchino
Taliani, Gloria
Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score
title Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score
title_full Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score
title_fullStr Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score
title_full_unstemmed Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score
title_short Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score
title_sort risk of seven-day worsening and death: a new clinically derived covid-19 score
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8951891/
https://www.ncbi.nlm.nih.gov/pubmed/35337049
http://dx.doi.org/10.3390/v14030642
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