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BackgroundWe sought to develop an automatable score to predict hospitalization, critical illness, or death in patients at risk for COVID-19 presenting for urgent care during the Massachusetts outbreak. MethodsSingle-center study of adult outpatients seen in respiratory illness clinics (RICs) or the emergency department (ED), including development (n = 9381, March 7-May 2) and prospective (n = 2205, May 3-14) cohorts. Data was queried from Partners Enterprise Data Warehouse. Outcomes were hospitalization, critical illness or death within 7 days. We developed the COVID-19 Acuity Score (CoVA) using automatically extracted data from the electronic medical record and learning-to-rank ordinal logistic regression modeling. Calibration was assessed using predicted-to-observed ratio (E/O). Discrimination was assessed by C-statistics (AUC). ResultsIn the development cohort, 27.3%, 7.2%, and 1.1% of patients experienced hospitalization, critical illness, or death, respectively; and in the prospective cohort, 26.1%, 6.3%, and 0.5%. CoVA showed excellent performance in the development cohort (concurrent validation) for hospitalization (E/O: 1.00, AUC: 0.80); for critical illness (E/O: 1.00, AUC: 0.82); and for death (E/O: 1.00, AUC: 0.87). Performance in the prospective cohort (prospective validation) was similar for hospitalization (E/O: 1.01, AUC: 0.76); for critical illness (E/O 1.03, AUC: 0.79); and for death (E/O: 1.63, AUC=0.93). Among 30 predictors, the top five were age, diastolic blood pressure, blood oxygen saturation, COVID-19 testing status, and respiratory rate. ConclusionsCoVA is a prospectively validated automatable score to assessing risk for adverse outcomes related to COVID-19 infection in the outpatient setting.
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Objective To investigate the genetic polym orphism s of 21 autosom al STR loci of Fujian H an population and evaluate the forensic application value of GlobalFilerTM E xpress kit. Methods A m plified w ith GlobalFilerTM E xpress kit, DNA sam ples were obtained from 741 unrelated individuals of Fujian H an population. The population genetics param eters of 21 autosom al STR loci were calculated. Results The 21 autosom al STR loci were found to be no deviation from Hardy-Weinberg equilibration (P>0.05) and relatively abundant in high polym orphism . H eterozygosity ranged from 0.589 to 0.914, pow er of dis-crim ination ranged from 0.754 to 0.992, polym orphic inform ation content ranged from 0.520 to 0.940, and pow er of exclusion ranged from 0.278 to 0.825. The SE33 locus was the highest degree in poly-m orphism . Conclusion The 21 STR loci of GlobalFilerTM E xpress kit have high value in discrim ination pow er and can be useful in personal identification and paternity test in Fujian H an population.
