| Autor: |
Qiongya Wang, Li Liu, Rui Xin, Changzheng Hu, Sichun Yin, Qinglang Zeng, Lu Tang, Zheng Zhang, Lisi Deng, Xilin Zhang, Jing Yuan, Jinyu Xia, Shufang Hu, Xiaoping Tang, Jiatao Lu, Boliang Zhao, Baolin Liao, Xueru Yin, Yabing Guo, Rong Fan, Zhihong Liu, Min-Feng Liang, Ridong He, Zhanzhou Lin, Mingxing Huang, Jian Sun, Jinlin Hou, Fuchun Zhang, Lei Liu, Yingxia Liu |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
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| DOI: |
10.1101/2020.04.17.20064691 |
| Popis: |
BackgroundSince the pandemic outbreak of coronavirus disease 2019 (COVID-19), the health system capacity in highly endemic areas has been overwhelmed. Approaches to efficient management are urgently needed. We aimed to develop and validate a score for early prediction of clinical deterioration of COVID-19 patients.MethodsIn this retrospective multicenter cohort study, we included 1138 mild to moderate COVID-19 patients admitted to 33 hospitals in Guangdong Province from December 27, 2019 to March 4, 2020 (N =818; training cohort), as well as two hospitals in Hubei Province from January 21 to February 22, 2020 (N =320; validation cohort) in the analysis.ResultsThe 14-day cumulative incidences of clinical deterioration were 7.9% and 12.1% in the training and validation cohorts, respectively. An Early WArning Score (EWAS) (ranging from 0 to 4.5), comprising of age, underlying chronic disease, neutrophil to lymphocyte ratio, C-reactive protein, and D-dimer levels, was developed (AUROC: 0.857). By applying the EWAS, patients were categorized into low-, medium-, and high risk groups (cut-off values: two and three). The 14-day cumulative incidence of clinical deterioration in the low-risk group was 1.8%, which was significantly lower than the incidence rates in the medium-(14.4%) and high-risk (40.9%) groups (P ConclusionThe EWAS, which is based on five common parameters, can predict COVID-19-related clinical deterioration and may be a useful tool for a rapid triage and establishing a COVID-19 hierarchical management system that will greatly focus clinical management and medical resources to reduce mortality in highly endemic areas. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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