Predicting severe outcomes in Covid-19 related illness using only patient demographics, comorbidities and symptoms.
Am J Emerg Med
; 45: 378-384, 2021 Jul.
Article
in English
| MEDLINE | ID: covidwho-754024
ABSTRACT
OBJECTIVE:
Development of a risk-stratification model to predict severe Covid-19 related illness, using only presenting symptoms, comorbidities and demographic data. MATERIALS ANDMETHODS:
We performed a case-control study with cases being those with severe disease, defined as ICU admission, mechanical ventilation, death or discharge to hospice, and controls being those with non-severe disease. Predictor variables included patient demographics, symptoms and past medical history. Participants were 556 patients with laboratory confirmed Covid-19 and were included consecutively after presenting to the emergency department at a tertiary care center from March 1, 2020 to April 21, 2020RESULTS:
Most common symptoms included cough (82%), dyspnea (75%), and fever/chills (77%), with 96% reporting at least one of these. Multivariable logistic regression analysis found that increasing age (adjusted odds ratio [OR], 1.05; 95% confidence interval [CI], 1.03-1.06), dyspnea (OR, 2.56; 95% CI 1.51-4.33), male sex (OR, 1.70; 95% CI 1.10-2.64), immunocompromised status (OR, 2.22; 95% CI 1.17-4.16) and CKD (OR, 1.76; 95% CI 1.01-3.06) were significant predictors of severe Covid-19 infection. Hyperlipidemia was found to be negatively associated with severe disease (OR, 0.54; 95% CI 0.33-0.90). A predictive equation based on these variables demonstrated fair ability to discriminate severe vs non-severe outcomes using only this historical information (AUC 0.76).CONCLUSIONS:
Severe Covid-19 illness can be predicted using data that could be obtained from a remote screening. With validation, this model could possibly be used for remote triage to prioritize evaluation based on susceptibility to severe disease while avoiding unnecessary waiting room exposure.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Triage
/
Pandemics
/
COVID-19
/
Hospitalization
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
North America
Language:
English
Journal:
Am J Emerg Med
Year:
2021
Document Type:
Article
Affiliation country:
J.ajem.2020.09.017
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