Development and validation of the HNC-LL score for predicting the severity of coronavirus disease 2019.
EBioMedicine
; 57: 102880, 2020 Jul.
Artículo
en Inglés
| MEDLINE | ID: covidwho-633891
ABSTRACT
BACKGROUND:
Information regarding risk factors associated with severe coronavirus disease (COVID-19) is limited. This study aimed to develop a model for predicting COVID-19 severity.METHODS:
Overall, 690 patients with confirmed COVID-19 were recruited between 1 January and 18 March 2020 from hospitals in Honghu and Nanchang; finally, 442 patients were assessed. Data were categorised into the training and test sets to develop and validate the model, respectively.FINDINGS:
A predictive HNC-LL (Hypertension, Neutrophil count, C-reactive protein, Lymphocyte count, Lactate dehydrogenase) score was established using multivariate logistic regression analysis. The HNC-LL score accurately predicted disease severity in the Honghu training cohort (area under the curve [AUC]=0.861, 95% confidence interval [CI] 0.800-0.922; P<0.001); Honghu internal validation cohort (AUC=0.871, 95% CI 0.769-0.972; P<0.001); and Nanchang external validation cohort (AUC=0.826, 95% CI 0.746-0.907; P<0.001) and outperformed other models, including CURB-65 (confusion, uraemia, respiratory rate, BP, age ≥65 years) score model, MuLBSTA (multilobular infiltration, hypo-lymphocytosis, bacterial coinfection, smoking history, hypertension, and age) score model, and neutrophil-to-lymphocyte ratio model. The clinical significance of HNC-LL in accurately predicting the risk of future development of severe COVID-19 was confirmed.INTERPRETATION:
We developed an accurate tool for predicting disease severity among COVID-19 patients. This model can potentially be used to identify patients at risks of developing severe disease in the early stage and therefore guide treatment decisions.FUNDING:
This work was supported by the National Nature Science Foundation of China (grant no. 81972897) and Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme (2015).Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Neumonía Viral
/
Índice de Severidad de la Enfermedad
/
Infecciones por Coronavirus
Tipo de estudio:
Estudio de cohorte
/
Estudios diagnósticos
/
Estudio observacional
/
Estudio pronóstico
Límite:
Femenino
/
Humanos
/
Masculino
/
Middle aged
Idioma:
Inglés
Revista:
EBioMedicine
Año:
2020
Tipo del documento:
Artículo
País de afiliación:
J.ebiom.2020.102880
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