Development and validation of a prognostic risk score system for COVID-19 inpatients: A multi-center retrospective study in China (preprint)

Coronavirus Disease 2019 (COVID-19) has become a world-wide pandemic. Hospitalized patients of COVID-19 suffer from a high mortality rate, motivating the development of convenient and practical methods for clinicians to promptly identify high-risk patients. Here we developed a risk score using clinical data from 1,479 inpatients admitted to Tongji Hospital, Wuhan, China (development cohort) and externally validated with data from two other centers: 141 inpatients from Jinyintan Hospital in Wuhan (validation cohort 1) and 432 inpatients from the Third People’s Hospital Shenzhen (validation cohort 2). The risk score is based on three biomarkers readily available in routine blood samples and can be easily translated into a probability of death. The risk score can predict the mortality of individual patients more than 12 days in advance with more than 90% accuracy across all cohorts. Moreover, the Kaplan-Meier score shows that patients upon admission can clearly be differenciated into low, medium or high risk, with an AUC score of 0.9551. In summary, a simple risk score was validated to predict death in patients infected with COVID-19 and was validated in independent cohorts.

The focus and timing of COVID-19 pandemic control measures under healthcare resource constraints (preprint)

Generalizing COVID-19 control strategies in one community to others is confounded by community's unique demographic and socioeconomic attributes. Here we propose a tailored dynamic model accounting for community-specific transmission controls and medical resource availability. We trained the model using data from Wuhan and applied it to other countries. We show that isolating suspected cases is most effective in reducing transmission rate if the intervention starts early. Having more hospital beds provides leverage that diminishes with delayed intervention onset. The importance of transmission control in turn increases by 65% with a 7-day delay. Furthermore, prolonging outbreak duration by applying an intermediate, rather than strict, transmission control would not prevent hospital overload regardless of bed capacity, and would likely result in a high ratio (21% ~ 84%) of the population being infected but not treated. The model could help different countries design control policies and gauge the severity of suppression failure.