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Development and validation of a clinical score to estimate progression to severe or critical state in COVID-19 pneumonia hospitalized patients.
Gude, Francisco; Riveiro, Vanessa; Rodríguez-Núñez, Nuria; Ricoy, Jorge; Lado-Baleato, Óscar; Lourido, Tamara; Rábade, Carlos; Lama, Adriana; Casal, Ana; Abelleira-París, Romina; Ferreiro, Lucía; Suárez-Antelo, Juan; Toubes, María E; Pou, Cristina; Taboada-Muñiz, Manuel; Calle-Velles, Felipe; Mayán-Conesa, Plácido; Del Molino, María L Pérez; Galbán-Rodríguez, Cristóbal; Álvarez-Escudero, Julián; Beceiro-Abad, Carmen; Molinos-Castro, Sonia; Agra-Vázquez, Néstor; Pazo-Núñez, María; Páez-Guillán, Emilio; Varela-García, Pablo; Martínez-Rey, Carmen; Pernas-Pardavila, Hadrián; Domínguez-Santalla, María J; Vidal-Vázquez, Martín; Marques-Afonso, Ana T; González-Quintela, Arturo; González-Juanatey, José R; Pose, Antonio; Valdés, Luis.
  • Gude F; Research Methods Group, Epidemiology Department, Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Riveiro V; Pulmonology Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Rodríguez-Núñez N; Pulmonology Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Ricoy J; Pulmonology Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Lado-Baleato Ó; Department of Statistics, Mathematical Analysis, and Optimization, University of Santiago de Compostela, Santiago de Compostela, Spain.
  • Lourido T; Pulmonology Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Rábade C; Pulmonology Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Lama A; Pulmonology Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Casal A; Pulmonology Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Abelleira-París R; Pulmonology Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Ferreiro L; Pulmonology Department, Interdisciplinary Group of Research in Pulmonology, University Clinical Hospital of Santiago, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain. lferfer7@gmail.com.
  • Suárez-Antelo J; Pulmonology Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Toubes ME; Pulmonology Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Pou C; Pulmonology Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Taboada-Muñiz M; Anesthesiology Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Calle-Velles F; Primary Health Care, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Mayán-Conesa P; Emergency Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Del Molino MLP; Microbiology Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Galbán-Rodríguez C; Intensive Care Unit, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Álvarez-Escudero J; Anesthesiology Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Beceiro-Abad C; Internal Medicine Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Molinos-Castro S; Internal Medicine Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Agra-Vázquez N; Internal Medicine Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Pazo-Núñez M; Internal Medicine Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Páez-Guillán E; Internal Medicine Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Varela-García P; Internal Medicine Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Martínez-Rey C; Internal Medicine Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Pernas-Pardavila H; Internal Medicine Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Domínguez-Santalla MJ; Internal Medicine Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Vidal-Vázquez M; Internal Medicine Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Marques-Afonso AT; Internal Medicine Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • González-Quintela A; Internal Medicine Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • González-Juanatey JR; Cardiology Department, CIBERCV, Health Research Institute (IDIS), University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Pose A; Internal Medicine Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain.
  • Valdés L; Pulmonology Department, Interdisciplinary Group of Research in Pulmonology, University Clinical Hospital of Santiago, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
Sci Rep ; 10(1): 19794, 2020 11 13.
Article in English | MEDLINE | ID: covidwho-927620
Semantic information from SemMedBD (by NLM)
1. Pneumonia caused by SARS-CoV-2 PROCESS_OF hospitalized patients
Subject
Pneumonia caused by SARS-CoV-2
Predicate
PROCESS_OF
Object
hospitalized patients
2. Borg Category-Ratio 10 Perceived Exertion Score 5 PROCESS_OF hospitalized patients
Subject
Borg Category-Ratio 10 Perceived Exertion Score 5
Predicate
PROCESS_OF
Object
hospitalized patients
3. Pneumonia caused by SARS-CoV-2 PROCESS_OF Patients
Subject
Pneumonia caused by SARS-CoV-2
Predicate
PROCESS_OF
Object
Patients
4. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
5. Invasive mechanical ventilation NOS TREATS Severe disease
Subject
Invasive mechanical ventilation NOS
Predicate
TREATS
Object
Severe disease
6. Risk Scores PREDISPOSES Disease Progression
Subject
Risk Scores
Predicate
PREDISPOSES
Object
Disease Progression
7. Pneumonia caused by SARS-CoV-2 PROCESS_OF hospitalized patients
Subject
Pneumonia caused by SARS-CoV-2
Predicate
PROCESS_OF
Object
hospitalized patients
8. Borg Category-Ratio 10 Perceived Exertion Score 5 PROCESS_OF hospitalized patients
Subject
Borg Category-Ratio 10 Perceived Exertion Score 5
Predicate
PROCESS_OF
Object
hospitalized patients
9. Pneumonia caused by SARS-CoV-2 PROCESS_OF Patients
Subject
Pneumonia caused by SARS-CoV-2
Predicate
PROCESS_OF
Object
Patients
10. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
11. Invasive mechanical ventilation NOS TREATS Severe disease
Subject
Invasive mechanical ventilation NOS
Predicate
TREATS
Object
Severe disease
12. Risk Scores PREDISPOSES Disease Progression
Subject
Risk Scores
Predicate
PREDISPOSES
Object
Disease Progression
ABSTRACT
The prognosis of a patient with COVID-19 pneumonia is uncertain. Our objective was to establish a predictive model of disease progression to facilitate early decision-making. A retrospective study was performed of patients admitted with COVID-19 pneumonia, classified as severe (admission to the intensive care unit, mechanic invasive ventilation, or death) or non-severe. A predictive model based on clinical, laboratory, and radiological parameters was built. The probability of progression to severe disease was estimated by logistic regression analysis. Calibration and discrimination (receiver operating characteristics curves and AUC) were assessed to determine model performance. During the study period 1152 patients presented with SARS-CoV-2 infection, of whom 229 (19.9%) were admitted for pneumonia. During hospitalization, 51 (22.3%) progressed to severe disease, of whom 26 required ICU care (11.4); 17 (7.4%) underwent invasive mechanical ventilation, and 32 (14%) died of any cause. Five predictors determined within 24 h of admission were identified Diabetes, Age, Lymphocyte count, SaO2, and pH (DALSH score). The prediction model showed a good clinical performance, including discrimination (AUC 0.87 CI 0.81, 0.92) and calibration (Brier score = 0.11). In total, 0%, 12%, and 50% of patients with severity risk scores ≤ 5%, 6-25%, and > 25% exhibited disease progression, respectively. A risk score based on five factors predicts disease progression and facilitates early decision-making according to prognosis.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / COVID-19 Type of study: Observational study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Sci Rep Year: 2020 Document Type: Article Affiliation country: S41598-020-75651-z

Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / COVID-19 Type of study: Observational study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Sci Rep Year: 2020 Document Type: Article Affiliation country: S41598-020-75651-z