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SARS-CoV-2 infection and cardiovascular or pulmonary complications in ambulatory care: A risk assessment based on routine data.
Karapetyan, Siranush; Schneider, Antonius; Linde, Klaus; Donnachie, Ewan; Hapfelmeier, Alexander.
  • Karapetyan S; Institute of General Practice and Health Services Research, School of Medicine, Technical University of Munich, Munich, Bavaria, Germany.
  • Schneider A; Institute of General Practice and Health Services Research, School of Medicine, Technical University of Munich, Munich, Bavaria, Germany.
  • Linde K; Institute of General Practice and Health Services Research, School of Medicine, Technical University of Munich, Munich, Bavaria, Germany.
  • Donnachie E; Bavarian Association of Statutory Health Insurance Physicians, Munich, Bavaria, Germany.
  • Hapfelmeier A; Institute of General Practice and Health Services Research, School of Medicine, Technical University of Munich, Munich, Bavaria, Germany.
PLoS One ; 16(10): e0258914, 2021.
Article in English | MEDLINE | ID: covidwho-1480460
ABSTRACT

BACKGROUND:

Risk factors of severe COVID-19 have mainly been investigated in the hospital setting. We investigated pre-defined risk factors for testing positive for SARS-CoV-2 infection and cardiovascular or pulmonary complications in the outpatient setting.

METHODS:

The present cohort study makes use of ambulatory claims data of statutory health insurance physicians in Bavaria, Germany, with polymerase chain reaction (PCR) test confirmed or excluded SARS-CoV-2 infection in first three quarters of 2020. Statistical modelling and machine learning were used for effect estimation and for hypothesis testing of risk factors, and for prognostic modelling of cardiovascular or pulmonary complications.

RESULTS:

A cohort of 99 811 participants with PCR test was identified. In a fully adjusted multivariable regression model, dementia (odds ratio (OR) = 1.36), type 2 diabetes (OR = 1.14) and obesity (OR = 1.08) were identified as significantly associated with a positive PCR test result. Significant risk factors for cardiovascular or pulmonary complications were coronary heart disease (CHD) (OR = 2.58), hypertension (OR = 1.65), tobacco consumption (OR = 1.56), chronic obstructive pulmonary disease (COPD) (OR = 1.53), previous pneumonia (OR = 1.53), chronic kidney disease (CKD) (OR = 1.25) and type 2 diabetes (OR = 1.23). Three simple decision rules derived from prognostic modelling based on age, hypertension, CKD, COPD and CHD were able to identify high risk patients with a sensitivity of 74.8% and a specificity of 80.0%.

CONCLUSIONS:

The decision rules achieved a high prognostic accuracy non-inferior to complex machine learning methods. They might help to identify patients at risk, who should receive special attention and intensified protection in ambulatory care.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Coronary Disease / Renal Insufficiency, Chronic / Ambulatory Care / SARS-CoV-2 / COVID-19 / Hypertension Subject: Coronary Disease / Renal Insufficiency, Chronic / Ambulatory Care / SARS-CoV-2 / COVID-19 / Hypertension Type of study: Etiology study / Observational study / Prognostic study / Risk factors Language: English Journal: PLoS One Clinical aspect: Etiology / Prognosis Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Coronary Disease / Renal Insufficiency, Chronic / Ambulatory Care / SARS-CoV-2 / COVID-19 / Hypertension Subject: Coronary Disease / Renal Insufficiency, Chronic / Ambulatory Care / SARS-CoV-2 / COVID-19 / Hypertension Type of study: Etiology study / Observational study / Prognostic study / Risk factors Language: English Journal: PLoS One Clinical aspect: Etiology / Prognosis Year: 2021
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