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Risk stratification scores for hospitalization duration and disease progression in moderate and severe patients with COVID-19.
Huang, Jiaqi; Xu, Yu; Wang, Bin; Xiang, Ying; Wu, Na; Zhang, Wenjing; Xia, Tingting; Yuan, Zhiquan; Li, Chengying; Jia, Xiaoyue; Shan, Yifan; Chen, Menglei; Li, Qi; Bai, Li; Li, Yafei.
  • Huang J; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China.
  • Xu Y; Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of The Army Medical University, Chongqing, 400037, People's Republic of China.
  • Wang B; Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of The Army Medical University, Chongqing, 400037, People's Republic of China.
  • Xiang Y; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China.
  • Wu N; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China.
  • Zhang W; Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of The Army Medical University, Chongqing, 400037, People's Republic of China.
  • Xia T; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China.
  • Yuan Z; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China.
  • Li C; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China.
  • Jia X; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China.
  • Shan Y; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China.
  • Chen M; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China.
  • Li Q; Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of The Army Medical University, Chongqing, 400037, People's Republic of China.
  • Bai L; Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of The Army Medical University, Chongqing, 400037, People's Republic of China.
  • Li Y; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Chongqing, 400038, People's Republic of China. liyafei2008@tmmu.edu.cn.
BMC Pulm Med ; 21(1): 120, 2021 Apr 14.
Article in English | MEDLINE | ID: covidwho-1183526
ABSTRACT

BACKGROUND:

During outbreak of Coronavirus Disease 2019 (COVID-19), healthcare providers are facing critical clinical decisions based on the prognosis of patients. Decision support tools of risk stratification are needed to predict outcomes in patients with different clinical types of COVID-19.

METHODS:

This retrospective cohort study recruited 2425 patients with moderate or severe COVID-19. A logistic regression model was used to select and estimate the factors independently associated with outcomes. Simplified risk stratification score systems were constructed to predict outcomes in moderate and severe patients with COVID-19, and their performances were evaluated by discrimination and calibration.

RESULTS:

We constructed two risk stratification score systems, named as STPCAL (including significant factors in the prediction model number of clinical symptoms, the maximum body temperature during hospitalization, platelet count, C-reactive protein, albumin and lactate dehydrogenase) and TRPNCLP (including maximum body temperature during hospitalization, history of respiratory diseases, platelet count, neutrophil-to-lymphocyte ratio, creatinine, lactate dehydrogenase, and prothrombin time), to predict hospitalization duration for moderate patients and disease progression for severe patients, respectively. According to STPCAL score, moderate patients were classified into three risk categories for a longer hospital duration low (Score 0-1, median = 8 days, with less than 20.0% probabilities), intermediate (Score 2-6, median = 13 days, with 30.0-78.9% probabilities), high (Score 7-9, median = 19 days, with more than 86.5% probabilities). Severe patients were stratified into three risk categories for disease progression low risk (Score 0-5, with less than 12.7% probabilities), intermediate risk (Score 6-11, with 18.6-69.1% probabilities), and high risk (Score 12-16, with more than 77.9% probabilities) by TRPNCLP score. The two risk scores performed well with good discrimination and calibration.

CONCLUSIONS:

Two easy-to-use risk stratification score systems were built to predict the outcomes in COVID-19 patients with different clinical types. Identifying high risk patients with longer stay or poor prognosis could assist healthcare providers in triaging patients when allocating limited healthcare during COVID-19 outbreak.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / Disease Progression / Clinical Decision Rules / COVID-19 Testing / COVID-19 / Hospitalization Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: BMC Pulm Med Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / Disease Progression / Clinical Decision Rules / COVID-19 Testing / COVID-19 / Hospitalization Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: BMC Pulm Med Year: 2021 Document Type: Article