ABSTRACT
Severity prediction of COVID-19 remains one of the major clinical challenges for the ongoing pandemic. Here, we have recruited a 144 COVID-19 patient cohort consisting of training, validation, and internal test sets, longitudinally recorded 124 routine clinical and laboratory parameters, and built a machine learning model to predict the disease progression based on measurements from the first 12 days since the disease onset when no patient became severe. A panel of 11 routine clinical factors, including oxygenation index, basophil counts, aspartate aminotransferase, gender, magnesium, gamma glutamyl transpeptidase, platelet counts, activated partial thromboplastin time, oxygen saturation, body temperature and days after symptom onset, constructed a classifier for COVID-19 severity prediction, achieving accuracy of over 94%. Validation of the model in an independent cohort containing 25 patients achieved accuracy of 80%. The overall sensitivity, specificity, PPV and NPV were 0.70, 0.99, 0.93 and 0.93, respectively. Our model captured predictive dynamics of LDH and CK while their levels were in the normal range. This study presents a practical model for timely severity prediction and surveillance for COVID-19, which is freely available at webserver https://guomics.shinyapps.io/covidAI/.
ABSTRACT
Objective To understand the prevalence of negative life events and its association with depressive, anxiety symptoms and dissatisfaction of school life among middle school students in Shaoxing, and to provide scientific evidence for further interventions. Methods A total number of 3 197 students (including 1 134 urban and 2 063 town adolescents) were recruited from 2 middle schools in Shaoxing, their average age was (13.73 ± 1.03) years. The Multidimensional Life Events Rating Questionnaire for Middle School Students (MLERQ), Depression Self-rating Scale for Children (DSRSC) and Screening for Child Anxiety Related Emotional Disorders (SCARED) were used to assess the mental health status, while the school life satisfaction was evaluated by the School Life Satisfaction Rating Questionnaire for Adolescents (SLSRQA), and the data were analyzed by descriptive statistics and multivariate logistic regression models. Results The prevalence of the negative life events was 84.9%, unsatisfactory examination performance (48.6%), unreached the teacher's expectation (46.2%), parental chatter (41.4%), unbalanced learning (37.9%), and getting parents scold (27.6%) constituted the main negative life events. The prevalence of depressive symptom, anxiety symptom, and dissatisfaction of school life were significantly higher among middle school students living with negative life events (41.1%, 22.6%, 26.0%) than those without negative life events (20.9%, 3.5%, 16.5%), (?2=71.33, 94.78, 19.83, P<0.001). The prevalence of the psychosomatic health involvement significantly increased with the increase of the number of the dimensions and events (P<0.001). The multivariate logistic regression showed that negative life events were the risk factors of depression, anxiety and dissatisfaction of school life. Their OR values were 2.483 (1.951-3.160), 7.245 (4.411-11.899) and 1.733 (1.325-2.267), respectively. The risk of occurring mental symptoms among children with the number of dimensions≥4 and/or the number of events≥12 was two times higher than those of children without such increase in numbers of dimensions and events. Conclusion The status of negative life events is serious among middle school students in Shaoxing. There are statistical associations between negative life events and mental symptoms.
ABSTRACT
Objective To understand the prevalence of physical activity deficiency and its association with depressive, anxiety symptoms and dissatisfaction of school life among adolescents in Shaoxing, Zhejiang province. Method A total of 3 397 valid questionnaires from adolescents from 80 classes of 2 middle schools (including 1 420 urban and 1 977 town adolescents) were investigated for the study, their average age was (13.73±1.01) years. The Depression Self-rating Scale for Children (DSRSC) and Screen for Child Anxiety Related Emotional Disorders (SCARED) were used to assess the mental health status, while the dissatisfaction of school life was evaluated by the School Life Satisfaction Rating Questionnaire for Adolescent (SLRQA), and the data were analyzed by descriptive statistics and multivariate logistic regression models. Result The self-reported proportion of 3 397 adolescents with physical activity deficiency reached 78.5%, and the prevalence rate of depressive, anxiety symptoms and school life dissatisfaction were 55.2%, 18.9% and 31.1%, respectively. Adjusting on other potential confounders, the result of multivariate logistic regression showed that girls engaged in less physical activities, the OR value (95%CI) was 1.597 (1.348-1.892), while the adolescents with town census register and adolescents having six or more close friends participated in more physical activities, their OR values were 0.785 (0.661-0.931) and 0.565 (0.355-0.900), and insufficient physical activity was positively associated with depressive, anxiety and dissatisfaction of their school lives, their OR values were respectively 1.783 (1.506-2.105), 2.141 (1.664-2.755) and 1.337 (1.101-1.621). Conclusion High prevalence of physical activity deficiency appeared among adolescents in Shaoxing and was closely related to the presence of depressive, anxiety symptoms and school life dissatisfaction.
