ABSTRACT
ABSTRACT: Early determination of coronavirus disease 2019 (COVID-19) pneumonia from numerous suspected cases is critical for the early isolation and treatment of patients.The purpose of the study was to develop and validate a rapid screening model to predict early COVID-19 pneumonia from suspected cases using a random forest algorithm in China.A total of 914 initially suspected COVID-19 pneumonia in multiple centers were prospectively included. The computer-assisted embedding method was used to screen the variables. The random forest algorithm was adopted to build a rapid screening model based on the training set. The screening model was evaluated by the confusion matrix and receiver operating characteristic (ROC) analysis in the validation.The rapid screening model was set up based on 4 epidemiological features, 3 clinical manifestations, decreased white blood cell count and lymphocytes, and imaging changes on chest X-ray or computed tomography. The area under the ROC curve was 0.956, and the model had a sensitivity of 83.82% and a specificity of 89.57%. The confusion matrix revealed that the prospective screening model had an accuracy of 87.0% for predicting early COVID-19 pneumonia.Here, we developed and validated a rapid screening model that could predict early COVID-19 pneumonia with high sensitivity and specificity. The use of this model to screen for COVID-19 pneumonia have epidemiological and clinical significance.
Subject(s)
Algorithms , COVID-19 Testing/methods , COVID-19/diagnosis , Mass Screening/methods , SARS-CoV-2/isolation & purification , Adult , China , Female , Humans , Male , Middle Aged , Prospective Studies , ROC Curve , Sensitivity and SpecificityABSTRACT
Novel coronavirus pneumonia (NCP) has been widely spread in China and several other countries. Early finding of this pneumonia from huge numbers of suspects gives clinicians a big challenge. The aim of the study was to develop a rapid screening model for early predicting NCP in a Zhejiang population, as well as its utility in other areas. A total of 880 participants who were initially suspected of NCP from January 17 to February 19 were included. Potential predictors were selected via stepwise logistic regression analysis. The model was established based on epidemiological features, clinical manifestations, white blood cell count, and pulmonary imaging changes, with the area under receiver operating characteristic (AUROC) curve of 0.920. At a cut-off value of 1.0, the model could determine NCP with a sensitivity of 85% and a specificity of 82.3%. We further developed a simplified model by combining the geographical regions and rounding the coefficients, with the AUROC of 0.909, as well as a model without epidemiological factors with the AUROC of 0.859. The study demonstrated that the screening model was a helpful and cost-effective tool for early predicting NCP and had great clinical significance given the high activity of NCP.
Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , Mass Screening , Models, Biological , Pneumonia/diagnosis , SARS-CoV-2/physiology , Adult , China/epidemiology , Female , Humans , Male , Middle Aged , ROC CurveABSTRACT
BACKGROUND: No data is available about in-flight transmission of SARS-CoV-2. Here, we report an in-flight transmission cluster of COVID-19 and describe the clinical characteristics of these patients. METHODS: After a flight, laboratory-confirmed COVID-19 was reported in 12 patients. Ten patients were admitted to the designated hospital. Data was collected from 25th January to 28th February 2020. Clinical information was retrospectively collected. RESULTS: All patients were passengers, and none were flight attendants. The median age was 33 years, and 70% were females. None was admitted to intensive care unit, and no patients died up to 28th February. The median incubation period was 3.0 days and time from onset of illness to hospital admission was 2 days. The most common symptom was fever. Two patients were asymptomatic and had normal chest CT scan during hospital stay. On admission, initial RT-PCR was positive in 9 patients, and initial chest CT was positive in half of the patients. The median lung 'total severity score' of chest CT was 6. 'Crazy-paving' pattern, pleural effusion, and ground-glass nodules were seen. CONCLUSION: There is potential for COVID-19 transmission in aeroplanes, but the symptoms were mild in our patients. Passengers and attendants must be protected during flights.