Predicting the risk of severe COVID-19 outcomes in primary care: development and validation of a vulnerability index for equitable allocation of effective vaccines.
Expert Rev Vaccines
; 21(3): 377-384, 2022 03.
Article
in English
| MEDLINE | ID: covidwho-1574830
ABSTRACT
BACKGROUND:
General practitioners (GPs) need a valid, user-friendly tool to identify patients most vulnerable to COVID-19, especially in the hypothesis of a booster vaccine dose. The aim of this study was to develop and validate a GP-friendly prognostic index able to forecast severe COVID-19 outcomes in primary care. Indeed, no such prognostic score is as yet available in Italy. RESEARCH DESIGN ANDMETHODS:
In this retrospective cohort study, a representative sample of 47,868 Italian adults were followed up for 129,000 person-months. The study outcome was COVID-19-related hospitalization and/or death. Candidate predictors were chosen on the basis of systematic evidence and current recommendations. The model was calibrated by using Cox regression. Both internal and external validations were performed.RESULTS:
Age, sex and several clinical characteristics were significantly associated with severe outcomes. The final multivariable model explained 60% (95%CI 58-63%) of variance for COVID-19-related hospitalizations and/or deaths. The area under the receiver-operator curve (AUC) was 84% (95% CI 83-85%). On applying the index to an external cohort, the AUC was 94% (95% CI 93-95%).CONCLUSIONS:
This index is a reliable prognostic tool that can help GPs to prioritize their patients for preventive and therapeutic interventions.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Vaccines
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Systematic review/Meta Analysis
Topics:
Vaccines
Limits:
Adult
/
Humans
Language:
English
Journal:
Expert Rev Vaccines
Journal subject:
Allergy and Immunology
Year:
2022
Document Type:
Article
Affiliation country:
14760584.2022.2019582
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