Prediction for Progression Risk in Patients With COVID-19 Pneumonia: The CALL Score.
Clin Infect Dis
; 71(6): 1393-1399, 2020 09 12.
Article
in English
| MEDLINE | ID: covidwho-47129
ABSTRACT
BACKGROUND:
We aimed to clarify high-risk factors for coronavirus disease 2019 (COVID-19) with multivariate analysis and establish a predictive model of disease progression to help clinicians better choose a therapeutic strategy.METHODS:
All consecutive patients with COVID-19 admitted to Fuyang Second People's Hospital or the Fifth Medical Center of Chinese PLA General Hospital between 20 January and 22 February 2020 were enrolled and their clinical data were retrospectively collected. Multivariate Cox regression was used to identify risk factors associated with progression, which were then were incorporated into a nomogram to establish a novel prediction scoring model. ROC was used to assess the performance of the model.RESULTS:
Overall, 208 patients were divided into a stable group (n = 168, 80.8%) and a progressive group (n = 40,19.2%) based on whether their conditions worsened during hospitalization. Univariate and multivariate analyses showed that comorbidity, older age, lower lymphocyte count, and higher lactate dehydrogenase at presentation were independent high-risk factors for COVID-19 progression. Incorporating these 4 factors, the nomogram achieved good concordance indexes of .86 (95% confidence interval [CI], .81-.91) and well-fitted calibration curves. A novel scoring model, named as CALL, was established; its area under the ROC was .91 (95% CI, .86-.94). Using a cutoff of 6 points, the positive and negative predictive values were 50.7% (38.9-62.4%) and 98.5% (94.7-99.8%), respectively.CONCLUSIONS:
Using the CALL score model, clinicians can improve the therapeutic effect and reduce the mortality of COVID-19 with more accurate and efficient use of medical resources.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Severity of Illness Index
/
Coronavirus Infections
/
Betacoronavirus
/
Clinical Decision Rules
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
English
Journal:
Clin Infect Dis
Journal subject:
Communicable Diseases
Year:
2020
Document Type:
Article
Affiliation country:
Cid
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