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1.
Preventive Medicine Reports ; 27:101812, 2022.
Article in English | ScienceDirect | ID: covidwho-1821455

ABSTRACT

Given the need to increase COVID-19 vaccine uptake among US young adults, we examined the extent of COVID-19 vaccine hesitancy in this population and related factors. We analyzed Fall 2020 survey data from 2,453 young adults (ages 18–34) across 6 US metropolitan statistical areas (MSAs;Meanage = 24.67;55.8% female;5.4% Black, 12.7% Asian, 11.1% Hispanic;75.5% college degree or higher). Multivariable linear regression examined correlates of COVID-19 vaccine hesitancy (index score of willingness and likelihood of being vaccinated), including sociopolitical factors (MSA, political orientation, COVID-related news exposure), COVID-19 symptoms and testing, mental health (e.g., COVID-related stress), and sociodemographics. 45.3% were “extremely willing” to get the vaccine (19.8% very, 14.2% somewhat, 3.7% don’t know, 7.0% a little, 10.1% not at all);40.2% were “extremely likely” to get vaccinated (22.1% very, 14.2% somewhat, 5.2% don’t know, 7.9% a little, 10.3% not at all). Greater vaccine hesitancy was significantly related to living in specific MSAs (i.e., Atlanta, Oklahoma City, San Diego, Seattle vs. Minneapolis or Boston), identifying as Republican or “no lean” (vs. Democrat), and reporting less COVID-related news exposure and less COVID-related stress, as well as identifying as older, female, Black or other race, having less (vs. greater) than a college education, being married/cohabitating, and having children in the home. Interventions to improve COVID-19 vaccine uptake among hesitant young adults should include communication that address concerns, particularly among women, minority groups, and those from certain geographic regions and/or differing political orientations, and require identifying communication channels that appeal to these groups.

2.
Journal of Shandong University ; 58(3):62-64, 2020.
Article in Chinese | GIM | ID: covidwho-1813134

ABSTRACT

Objective: To enhance the understanding of novel coronavirus pneumonia (NCP) in children, to provide reference for the early diagnosis and treatment and to prevent misdiagnosis.

3.
Journal of Shandong University ; 58(4):62-64, 2020.
Article in English, Chinese | GIM | ID: covidwho-1812853

ABSTRACT

Objective: To describe and analyze the epidemiological characteristics of patients with coronavirus disease 2019(COVID-19) treated at a designated hospital in Jinan from 0:00, Jan. 23 to 12:00, Feb. 5, 2020.

4.
Infect Dis Poverty ; 11(1): 19, 2022 Feb 17.
Article in English | MEDLINE | ID: covidwho-1759783

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is still ongoing spreading globally, machine learning techniques were used in disease diagnosis and to predict treatment outcomes, which showed favorable performance. The present study aims to predict COVID-19 severity at admission by different machine learning techniques including random forest (RF), support vector machine (SVM), and logistic regression (LR). Feature importance to COVID-19 severity were further identified. METHODS: A retrospective design was adopted in the JinYinTan Hospital from January 26 to March 28, 2020, eighty-six demographic, clinical, and laboratory features were selected with LassoCV method, Spearman's rank correlation, experts' opinions, and literature evaluation. RF, SVM, and LR were performed to predict severe COVID-19, the performance of the models was compared by the area under curve (AUC). Additionally, feature importance to COVID-19 severity were analyzed by the best performance model. RESULTS: A total of 287 patients were enrolled with 36.6% severe cases and 63.4% non-severe cases. The median age was 60.0 years (interquartile range: 49.0-68.0 years). Three models were established using 23 features including 1 clinical, 1 chest computed tomography (CT) and 21 laboratory features. Among three models, RF yielded better overall performance with the highest AUC of 0.970 than SVM of 0.948 and LR of 0.928, RF also achieved a favorable sensitivity of 96.7%, specificity of 69.5%, and accuracy of 84.5%. SVM had sensitivity of 93.9%, specificity of 79.0%, and accuracy of 88.5%. LR also achieved a favorable sensitivity of 92.3%, specificity of 72.3%, and accuracy of 85.2%. Additionally, chest-CT had highest importance to illness severity, and the following features were neutrophil to lymphocyte ratio, lactate dehydrogenase, and D-dimer, respectively. CONCLUSIONS: Our results indicated that RF could be a useful predictive tool to identify patients with severe COVID-19, which may facilitate effective care and further optimize resources.


Subject(s)
COVID-19 , Humans , Logistic Models , Machine Learning , Middle Aged , Retrospective Studies , SARS-CoV-2
5.
China CDC Wkly ; 4(10): 195-198, 2022 Mar 11.
Article in English | MEDLINE | ID: covidwho-1737616

ABSTRACT

What is already known about this topic?: Coronavirus disease 2019 (COVID-19) causes symptoms ranging from mild to severe. Indicators for identifying severe COVID-19 infection have not been well identified, especially for young patients. What is added by this report?: Both neutrophil-lymphocyte ratio (NLR) [area under curve (AUC): 0.80; the odds ratios (OR) and 95% confidence intervals (95% CI): 1.30 (1.13-1.50)] and platelet-lymphocyte ratio (PLR) [AUC: 0.87; OR (95% CI): 1.05 (1.01-1.09)] were determined to be indicators for recognition of patients with severe COVID-19 in young patients less than age 40. What are the implications for public health practice?: NLR and PLR are useful indicators for identifying patients with severe COVID-19, especially in young patients less than age 40.

6.
Phytomedicine ; 95: 153868, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1720737

ABSTRACT

BACKGROUND: Huashibaidu Formula (HSBD) for the COVID-19 treatment has been supported by the China's Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia. However, it is not clear whether HSBD can improve blood oxygen saturation and when it should be used with conventional therapies. PURPOSE: To access the effect of HSBD combined with conventional treatment on blood oxygen saturation of COVID-19 patients. METHODS: A single-center retrospective cohort study was conducted to collect the confirmed severe COVID-19 patients' information, treated by the National Traditional Chinese Medicine Medical Team at the Jinyintan hospital between January 24 and March 31, 2020. According to whether HSBD was used during hospitalization, participants were separated into the conventional treatment group and the HSBD group (HSBD and conventional treatment). The primary observation indicators included the time for relieving blood oxygen saturation and the improvement ratio of blood oxygen saturation in each group. RESULTS: Of 111 patients with severe COVID-19, 53.2% (59/111) received HSBD, and 46.8% (52/111) only received conventional treatment, respectively. No statistically significant difference was found in image, clinical symptoms, and past medical history between the two groups (p > 0.05). Notably, the median time for relieving blood oxygen saturation in the conventional treatment group was 11 days (IQR, 8-14.25), while that in the HSBD group was only 6 days (IQR, 3.25-10.75), which was significantly shortened by 4.09 days (95%CI, 2.07-6.13; p= 0.0001), compared with the conventional treatment group. After repeated measurement design analysis, the main effect within times (p< 0.001) and the main effect were significantly different under the oxygen saturation dimension between two groups (p= 0.004). However, time and group interaction were observed no significant difference (p= 0.094). After 14 days of treatment, the improvement ratio of the HSBD group over the conventional treatment group was 1.20 (95%CI, 0.89-1.61). CONCLUSION: For severe COVID-19 patients, the HSBD has a tendency to shorten the time for relieving blood oxygen saturation. After taking a course of HSBD, the effect can be more obvious.


Subject(s)
COVID-19 , COVID-19/drug therapy , Humans , Retrospective Studies , SARS-CoV-2 , Treatment Outcome
7.
Healthc Q ; 24(4): 27-33, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1716159

ABSTRACT

The Ontario Ministry of Health funded a reintegration unit to transition hospitalized patients who no longer required acute care to alternate level of care (ALC), such as long-term care. In its first year, 102 (3.5%) patients of the hospital's waiting-for-ALC population were transferred, with 37.3% transferred on the day of ALC readiness. The reintegration unit reduced direct hospital costs by $861,000. Using case costing, we modelled optimized scenarios including all transfers on the day of ALC readiness and increased transfers to the reintegration unit; this helped reduce avoided direct costs by $2.3-$5.4 million. Acute-care bed capacity could have increased by 11%. We outline strategies to optimize future performance of the reintegration unit.


Subject(s)
Long-Term Care , Patient Discharge , Costs and Cost Analysis , Critical Care , Hospitals , Humans
8.
J Am Coll Emerg Physicians Open ; 3(1): e12616, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1712068

ABSTRACT

Objective: This study analyzed physician treating behavior through the use of a multiplex gastrointestinal polymerase chain reaction (GI PCR) test compared with usual testing in emergency department (ED) patients with suspected acute infectious diarrhea to assess differences in antibiotic management. Methods: A prospective, single-center, randomized control trial was designed to investigate antibiotic use in ED patients with moderate to severe suspected infectious diarrhea, comparing those who received GI PCR to those who received usual testing. ED patients with signs of dehydration, inflammation, or persistent symptoms were randomized to either the experimental arm (GI PCR) or the control arm (usual testing or no testing). Results: A total of 74 patients met study criteria and were randomized to either the experimental GI PCR arm (n = 38) or to the control arm (n = 36). Participants in the GI PCR arm received antibiotics in 87% of bacterial or protozoal diarrheal infections (13/15) whereas those in the control arm received antibiotics in 46% of bacterial or protozoal infections (6/13) (P value 0.042) with 2-proportion difference 0.41 (95% confidence interval 0.07 and 0.68). Conclusions: ED use of multiplex GI PCR led to an increase in antibiotic use for bacterial and protozoal causes of infectious diarrhea compared to usual testing. This increase in antibiotics appears to be appropriate given patients' moderate to severe symptoms and a definitive identification of a likely bacterial or protozoal cause of symptoms. Results should be interpreted with caution because of the small sample size.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324789

ABSTRACT

Background: Frontline epidemic prevention workers play a pivotal role against COVID-19. Their baseline of dietary and behavior habits and willingness to change these habits after experiencing the outbreak of COVID-19 remains unclear.Methods: A self-developed online questionnaire survey was carried out via the WeChat platform, and 22,459 participated, including 9402 frontline epidemic prevention workers.Findings: Before COVID-19, 23.9% of frontline epidemic prevention workers reported a high-salt diet, 46.9% reported a high frequency of fried food intake, 21.6% reported a low frequency of fresh vegetable intake, and 50.9% smoked cigarettes. After experiencing the outbreak of COVID-19, 34.6% had the willingness to reduce salt intake, and 43.7% want to reduce the frequency of pickled vegetable intake. 37.9% had the willingness to decrease or quit smoking, and 44.5% want to increase sleep duration. Significant differences in the baseline of dietary and behavioral habits and willingness to change their habits were observed between the frontline epidemic prevention worker and others(P<0.05). However, for the frontline epidemic prevention workers with poor dietary and behavioral habits, the frontline epidemic prevention experience might be a promoting factor to adopt worse dietary and behavioral habits, including the high-salt intake subgroup (OR 2.824, 95% CI 2.341-3.405) and shortest physical exercise time subgroup (OR 1.379, 95% CI 1.041-1.828).Interpretation: The dietary and behavior habits of the frontline epidemic prevention workers were worse than others before COVID-19. They had more willingness to adopt healthy dietary and behavior habits after experiencing the outbreak of COVID-19. Because the frontline epidemic prevention workers, who had poor dietary and behavior habits before COVID-19, still choose worse habits, dietary and behavior intervention policies should be drafted to protect their health, especially for those poor habits subgroups.Funding: This work was supported by The Science and Technology Project of Bao'an (NO.2020JD101).Declaration of Interests: The authors declare that they have no competing interests.Ethics Approval Statement: This study was approved by the ethics committee of Guangdong Medical University.

10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324331

ABSTRACT

Background: To investigate impact of the 2019 novel coronavirus disease (COVID-19) pandemic on willingness to adopt healthy dietary habits in China. Methods: : A survey was carried out, and subjective perception of impact due to COVID-19 and willingness to change dietary habits were obtained. Results: : A total of 22,459 subjects were derived from China, with an average age of 27.9±7.8 years old. Of them, the mean score of willingness to adopt healthy dietary habits was 2.2 (ranges from -9 to 9). Multivariate regression analysis showed that the impact of the COVID-19 pandemic (epidemic concern, impact of psychology, impact of work or study) are associated with a higher score of willingness to adopt healthy dietary habits among female, the older, on-medical worker, and individuals married or with higher education level, normal BMI. Conclusions: : There was a positive improvement to a proper diet, so the changing features of diets should be considered in nutritional interventions for maintaining health, and prevention and control COVID-19 during the pandemic period.

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324225

ABSTRACT

Background: COVID-19 has become a global pandemic. Studies about SARS-CoV-2 co-infection with influenza A virus (IAV) in the influenza season will contribute to the antiviral interventions of co-infected patients. Methods: : A cohort of 145 COVID-19 patients in Wuhan union hospital were reviewed and we found 2 patients were co-infected with both SARS-CoV-2 and IAV. Then we searched from PubMed, Web of Science and CNKI with combinations of the following key words: “COVID-19, SARS-COV-2, influenza A and co-infection” from January 1 up to May 1, and 6 studies were included in this descriptive analysis. Results: : Of the 13 co-infected patients, 2 were from Wuhan union hospital, another 11 were collected from the reports published on PubMed, Web of Science and CNKI. Of the 13 patients, the median age was 50 years (IQR, 40.5-67.5). Among the 13 patients, 7 (53.8%) were severe types. The most common symptoms among the 13 patients were cough (100%), fever (92.3%) and dyspnea (76.9%). 8 patients had lymphocytopenia on admission and all the 13 patients had abnormal radiological changes. The median time from symptom onset to hospital admission was 4.5 days (IQR, 2.75-5.5), and the median time of hospital stay was 17 days (IQR,15-20). Conclusion: Patients with both SARS-COV-2 and IAV infection showed similar changes in symptoms and radiological images with patients infected with SARS-COV-2 only. SARS-COV-2 co-infection with IAV can lead to more severe clinical condition but had similar hospital stay compared with patients infected with SARS-COV-2 only in the fast review.

12.
Chin J Integr Med ; 2022 Jan 13.
Article in English | MEDLINE | ID: covidwho-1633656

ABSTRACT

OBJECTIVES: To summarize the measures and rules of Chinese medicine (CM) and provide reference for clinical application in the prevention and treatment of coronavirus disease (COVID-19). METHODS: The data source was from CM COVID-19 prevention and treatment programs on government websites and official media websites of the different provinces and cities. The search lasted from December 8, 2019 to March 10, 2020. Main variables were medication frequency and combinations of medicines. Cluster analysis and complex network analysis were used by prevention and treatment stage and by area. RESULTS: Among 27 CM diagnosis and treatment plans, 203 therapeutic prescriptions were enrolled, of which the top 4 herbs were: Radix glycyrrhizae, Semen armeniacae amarum, Herba ephedrae, and Herba agastachis, respectively. The core combinations were Herba ephedrae and Semen armeniacae amarum. Forty-eight preventive formulae were identified. Ten herbs, including Radix Astragali seu hedysari, Radix glycyrrhizae, Radix saposhnikoviae, Flos lonicerae, etc. were most frequently used. The core prescription of CM compatibility was Radix astragali seu hedysari, Radix glycyrrhizae, and Radix saposhnikoviae, which is the main component of Yu Ping Feng San. There were 45 prevention and treatment prescriptions in East China; the most used CM was Radix glycyrrhizae, Herba agastachis, Pericarpium citri reticulatae, and Gypsum fibrosum. Fifty prescriptions were identified in North China. According to CM analyses, Herba agastachis, Semen armeniacae amarum, Herba ephedrae, and Poria were most frequently used. CONCLUSIONS: CM for COVID-19 prevention mainly focuses on improving human immunity; for treatment, prescription focuses on clearing the lungs and removing dampness. Prescriptions vary with regions, perhaps due to climatic and environmental differences, which help clinicians to quickly make CM plans and treat patients according to clinical status, further minimizing resource wastage.

13.
Biomed Environ Sci ; 34(12): 984-991, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-1608702

ABSTRACT

Objective: Early triage of patients with coronavirus disease 2019 (COVID-19) is pivotal in managing the disease. However, studies on the clinical risk score system of the risk factors for the development of severe disease are limited. Hence, we conducted a clinical risk score system for severe illness, which might optimize appropriate treatment strategies. Methods: We conducted a retrospective, single-center study at the JinYinTan Hospital from January 24, 2020 to March 31, 2020. We evaluated the demographic, clinical, and laboratory data and performed a 10-fold cross-validation to split the data into a training set and validation set. We then screened the prognostic factors for severe illness using the least absolute shrinkage and selection operator (LASSO) and logistic regression, and finally conducted a risk score to estimate the probability of severe illness in the training set. Data from the validation set were used to validate the score. Results: A total of 295 patients were included. From 49 potential risk factors, 3 variables were measured as the risk score: neutrophil to lymphocyte ratio ( OR, 1.27; 95% CI, 1.15-1.39), albumin ( OR, 0.76; 95% CI, 0.70-0.83), and chest computed tomography abnormalities ( OR, 2.01; 95% CI, 1.41-2.86) and the AUC of the validation cohort was 0.822 (95% CI, 0.7667-0.8776). Conclusion: This report may help define the potential of developing severe illness in patients with COVID-19 at an early stage, which might be related to the neutrophil to lymphocyte ratio, albumin, and chest computed tomography abnormalities.


Subject(s)
COVID-19/diagnosis , Risk Assessment , Aged , Female , Humans , Male , Middle Aged , Nomograms , Retrospective Studies , Severity of Illness Index
14.
Disease Surveillance ; 36(9):949-954, 2021.
Article in Chinese | GIM | ID: covidwho-1575968

ABSTRACT

Objective: To analyze the epidemiological characteristics of COVID-19 cases in Shayibake district of Urumqi of Xinjiang and provide scientific evidence for the prevention and control of COVID-19 epidemic.

15.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-292335

ABSTRACT

Background: Angiotensin-converting enzyme 2 (ACE2) is implicated as a host cell receptor that causes infection in the pathogenesis of Coronavirus disease 2019 (COVID-19), and its genetic polymorphisms in the ACE2 gene may promote cardiovascular disease and systemic inflammatory injury in COVID-19. Hence, genetic background may potentially explain the broad inter-individual variation of disease susceptibility and/or severity. Methods The genetic susceptibility to COVID-19 by examining single-nucleotide polymorphisms (SNPs) of ACE2 was analyzed in 196 patients with COVID-19 and 210 normal controls using TaqMan genotyping assay. Results We demonstrated that ACE2 SNP rs4646142, rs6632677, and rs2074192 were associated with COVID-19 (all P < 0.05), and the differences of ACE2 SNPs rs4646142 and rs6632677 were correlated with COVID-19 related systemic inflammatory injury and cardiovascular risk. Specially, rs4646142 was associated with high-sensitive C-reactive protein (hs-CRP), prealbumin (PAB), apolipoprotein A (APOA), high-density lipoprotein (HDL), and acid glycoprotein (AGP). Rs6632677 was also associated with elevated CRP and haptoglobin (HPT). Conclusions Our results suggest that early identification of these individuals can provide a possible strategy for preventing the spread of the COVID-19, and ACE2 SNPs rs4646142 and rs6632677 may be a common genetic loci and optimal early identification genetic marker for COVID-19 with cardiovascular risks.

16.
Cell Res ; 31(12): 1244-1262, 2021 12.
Article in English | MEDLINE | ID: covidwho-1493090

ABSTRACT

The infusion of coronavirus disease 2019 (COVID-19) patients with mesenchymal stem cells (MSCs) potentially improves clinical symptoms, but the underlying mechanism remains unclear. We conducted a randomized, single-blind, placebo-controlled (29 patients/group) phase II clinical trial to validate previous findings and explore the potential mechanisms. Patients treated with umbilical cord-derived MSCs exhibited a shorter hospital stay (P = 0.0198) and less time required for symptoms remission (P = 0.0194) than those who received placebo. Based on chest images, both severe and critical patients treated with MSCs showed improvement by day 7 (P = 0.0099) and day 21 (P = 0.0084). MSC-treated patients had fewer adverse events. MSC infusion reduced the levels of C-reactive protein, proinflammatory cytokines, and neutrophil extracellular traps (NETs) and promoted the maintenance of SARS-CoV-2-specific antibodies. To explore how MSCs modulate the immune system, we employed single-cell RNA sequencing analysis on peripheral blood. Our analysis identified a novel subpopulation of VNN2+ hematopoietic stem/progenitor-like (HSPC-like) cells expressing CSF3R and PTPRE that were mobilized following MSC infusion. Genes encoding chemotaxis factors - CX3CR1 and L-selectin - were upregulated in various immune cells. MSC treatment also regulated B cell subsets and increased the expression of costimulatory CD28 in T cells in vivo and in vitro. In addition, an in vivo mouse study confirmed that MSCs suppressed NET release and reduced venous thrombosis by upregulating kindlin-3 signaling. Together, our results underscore the role of MSCs in improving COVID-19 patient outcomes via maintenance of immune homeostasis.


Subject(s)
COVID-19/therapy , Immunomodulation , Mesenchymal Stem Cell Transplantation , Aged , Animals , Antibodies, Viral/blood , B-Lymphocyte Subsets/cytology , B-Lymphocyte Subsets/immunology , B-Lymphocyte Subsets/metabolism , C-Reactive Protein/analysis , COVID-19/immunology , COVID-19/virology , Cytokines/genetics , Cytokines/metabolism , Cytoskeletal Proteins/metabolism , Disease Models, Animal , Extracellular Traps/metabolism , Female , Humans , Leukocytes, Mononuclear/cytology , Leukocytes, Mononuclear/metabolism , Male , Mice , Mice, Inbred C57BL , Middle Aged , SARS-CoV-2/isolation & purification , T-Lymphocytes/cytology , T-Lymphocytes/immunology , T-Lymphocytes/metabolism , Venous Thrombosis/metabolism , Venous Thrombosis/pathology
17.
J Am Coll Emerg Physicians Open ; 2(5): e12579, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1490771

ABSTRACT

OBJECTIVE: In US emergency departments (EDs), the physician has limited ability to evaluate for common and serious conditions of the gastrointestinal (GI) mucosa such as a bleeding peptic ulcer. Although many bleeding lesions are self-limited, the majority of these patients require emergency hospitalization for upper endoscopy (EGD). We conducted a clinical trial to determine if ED risk stratification with video capsule endoscopy (VCE) reduces hospitalization rates for low-risk to moderate-risk patients with suspected upper GI bleeding. METHODS: We conducted a randomized controlled trial at 3 urban academic EDs. Inclusion criteria included signs of upper GI bleeding and a Glasgow Blatchford score <6. Patients were randomly assigned to 1 of the following 2 treatment arms: (1) an experimental arm that included VCE risk stratification and brief ED observation versus (2) a standard care arm that included admission for inpatient EGD. The primary outcome was hospital admission. Patients were followed for 7 and 30 days to assess for rebleeding events and revisits to the hospital. RESULTS: The trial was terminated early as a result of low accrual. The trial was also terminated early because of a need to repurpose all staff to respond to the coronavirus disease 2019 pandemic. A total of 24 patients were enrolled in the study. In the experimental group, 2/11 (18.2%) patients were admitted to the hospital, and in the standard of care group, 10/13 (76.9%) patients were admitted to the hospital (P = 0.012). There was no difference in safety on day 7 and day 30 after the index ED visit. CONCLUSIONS: VCE is a potential strategy to decrease admissions for upper GI bleeding, though further study with a larger cohort is required before this approach can be recommended.

19.
International Journal of Infectious Diseases ; 94:74-77, 2020.
Article in English | CAB Abstracts | ID: covidwho-1409683

ABSTRACT

Background: There are no clear expert consensus or guidelines on how to treat 2019 coronavirus disease (COVID-19). The objective of this study is to investigate the short-term effect of risk-adapted treatment strategy on patients with COVID-19.

20.
Front Med (Lausanne) ; 8: 699243, 2021.
Article in English | MEDLINE | ID: covidwho-1399148

ABSTRACT

Introduction: COVID-19 has overloaded worldwide medical facilities, leaving some potentially high-risk patients trapped in outpatient clinics without sufficient treatment. However, there is still a lack of a simple and effective tool to identify these patients early. Methods: A retrospective cohort study was conducted to develop an early warning model for predicting the death risk of COVID-19. Seventy-five percent of the cases were used to construct the prediction model, and the remaining 25% were used to verify the prediction model based on data immediately available on admission. Results: From March 1, 2020, to April 16, 2020, a total of 4,711 COVID-19 patients were included in our study. The average age was 63.37 ± 16.70 years, of which 1,148 (24.37%) died. Finally, age, SpO2, body temperature (T), and mean arterial pressure (MAP) were selected for constructing the model by univariate analysis, multivariate analysis, and a review of the literature. We used five common methods for constructing the model and finally found that the full model had the best specificity and higher accuracy. The area under the ROC curve (AUC), specificity, sensitivity, and accuracy of full model in train cohort were, respectively, 0.798 (0.779, 0.816), 0.804, 0.656, and 0.768, and in the validation cohort were, respectively, 0.783 (0.751, 0.815), 0.800, 0.616, and 0.755. Visualization tools of the prediction model included a nomogram and an online dynamic nomogram (https://wanghai.shinyapps.io/dynnomapp/). Conclusion: We developed a prediction model that might aid in the early identification of COVID-19 patients with a high probability of mortality on admission. However, further research is required to determine whether this tool can be applied for outpatient or home-based COVID-19 patients.

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