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Simple demographic characteristics and laboratory findings on admission may predict in-hospital mortality in patients with SARS-CoV-2 infection: development and validation of the covid-19 score.
Obremska, Marta; Pazgan-Simon, Monika; Budrewicz, Katarzyna; Bilaszewski, Lukasz; Wizowska, Joanna; Jagielski, Dariusz; Jankowska-Polanska, Beata; Nadolny, Klaudiusz; Madowicz, Jaroslaw; Zuwala-Jagiello, Jolanta; Zysko, Dorota; Banasiak, Waldemar; Simon, Krzysztof.
  • Obremska M; Department of Preclinical Research, Wroclaw Medical University, Wroclaw, Poland.
  • Pazgan-Simon M; Ist Department of Infectious Diseases Regional Specialistic Hospital, Wroclaw, Poland.
  • Budrewicz K; Department of Emergency Medicine, Wroclaw Medical University, ul. Borowska 213, 50-556, Wroclaw, Poland. katarzyna.budrewicz@umed.wroc.pl.
  • Bilaszewski L; Department of Emergency Medicine, Wroclaw Medical University, ul. Borowska 213, 50-556, Wroclaw, Poland.
  • Wizowska J; Department of Emergency Medicine, Wroclaw Medical University, ul. Borowska 213, 50-556, Wroclaw, Poland.
  • Jagielski D; Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland.
  • Jankowska-Polanska B; Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland.
  • Nadolny K; Department of Emergency Medical Service, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland.
  • Madowicz J; Faculty of Medicine, Katowice School of Technology, Katowice, Poland.
  • Zuwala-Jagiello J; Provincial Specialist Hospital, Tychy, Poland.
  • Zysko D; Department of Health Sciences, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland.
  • Banasiak W; Department of Pharmaceutical Biochemistry, Wroclaw Medical University, Wroclaw, Poland.
  • Simon K; Department of Emergency Medicine, Wroclaw Medical University, ul. Borowska 213, 50-556, Wroclaw, Poland.
BMC Infect Dis ; 21(1): 945, 2021 Sep 14.
Article in English | MEDLINE | ID: covidwho-1413302
ABSTRACT

BACKGROUND:

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) constitutes a major health burden worldwide due to high mortality rates and hospital bed shortages. SARS-CoV-2 infection is associated with several laboratory abnormalities. We aimed to develop and validate a risk score based on simple demographic and laboratory data that could be used on admission in patients with SARS-CoV-2 infection to predict in-hospital mortality.

METHODS:

Three cohorts of patients from different hospitals were studied consecutively (developing, validation, and prospective cohorts). The following demographic and laboratory data were obtained from medical records sex, age, hemoglobin, mean corpuscular volume (MCV), platelets, leukocytes, sodium, potassium, creatinine, and C-reactive protein (CRP). For each variable, classification and regression tree analysis were used to establish the cut-off point(s) associated with in-hospital mortality outcome based on data from developing cohort and before they were used for analysis in the validation and prospective cohort. The covid-19 score was calculated as a sum of cut-off points associated with mortality outcome.

RESULTS:

The developing, validation, and prospective cohorts included 129, 239, and 497 patients, respectively (median age, 71, 67, and 70 years, respectively). The following cut of points associated with in-hospital mortality age > 56 years, male sex, hemoglobin < 10.55 g/dL, MCV > 92.9 fL, leukocyte count > 9.635 or < 2.64 103/µL, platelet count, < 81.49 or > 315.5 103/µL, CRP > 51.14 mg/dL, creatinine > 1.115 mg/dL, sodium < 134.7 or > 145.4 mEq/L, and potassium < 3.65 or > 6.255 mEq/L. The AUC of the covid-19 score for predicting in-hospital mortality was 0.89 (0.84-0.95), 0.850 (0.75-0.88), and 0.773 (0.731-0.816) in the developing, validation, and prospective cohorts, respectively (P < 0.001The mortality of the prospective cohort stratified on the basis of the covid-19 score was as follows 0-2 points,4.2%; 3 points, 15%; 4 points, 29%; 5 points, 38.2%; 6 and more points, 60%.

CONCLUSION:

The covid-19 score based on simple demographic and laboratory parameters may become an easy-to-use, widely accessible, and objective tool for predicting mortality in hospitalized patients with SARS-CoV-2 infection.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Humans / Male / Infant, Newborn Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-06645-z

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Humans / Male / Infant, Newborn Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-06645-z