Factors Defining the Development of Severe Illness in Patients with COVID-19: A Retrospective Study
定义 COVID-19 患者重症发展的因素：一项回顾性研究
COVID-19患者の重篤な病気の発症を定義する要因：後ろ向き研究
COVID-19 환자의 중증 질환 발병을 정의하는 요인: 후향적 연구
Factores que definen el desarrollo de enfermedades graves en pacientes con COVID-19: un estudio retrospectivo
Facteurs définissant le développement d'une maladie grave chez les patients atteints de COVID-19 : une étude rétrospective
Факторы, определяющие развитие тяжелого заболевания у пациентов с COVID-19: ретроспективное исследование
XIONG Yi Bai 熊一白 ¹, TIAN Ya Xin 田亚欣 ¹, MA Yan 马艳 ¹, YANG Wei 杨伟 ¹, LIU Bin 刘斌 ¹, RUAN Lian Guo 阮连国 ², LU Cheng 吕诚 ¹, HUANG Lu Qi 黄璐琦 ³
¹ Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
中国 北京 中国中医科学院中医临床基础医学研究所
² Department of Infectious Diseases, JinYinTan Hospital, Wuhan 430024, Hubei, China
中国 湖北 武汉 金银潭医院感染性疾病科
³ National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100700, China
中国 北京 中国中医科学院中药资源中心
Biomedical and Environmental Sciences, 10 January 2022
Objective
Early triage of patients with coronavirus disease 2019 (COVID-19) is pivotal in managing the disease. However, studies on the clinical risk score system of the risk factors for the development of severe disease are limited. Hence, we conducted a clinical risk score system for severe illness, which might optimize appropriate treatment strategies.
Methods
We conducted a retrospective, single-center study at the JinYinTan Hospital from January 24, 2020 to March 31, 2020. We evaluated the demographic, clinical, and laboratory data and performed a 10-fold cross-validation to split the data into a training set and validation set. We then screened the prognostic factors for severe illness using the least absolute shrinkage and selection operator (LASSO) and logistic regression, and finally conducted a risk score to estimate the probability of severe illness in the training set. Data from the validation set were used to validate the score.
Results
A total of 295 patients were included. From 49 potential risk factors, 3 variables were measured as the risk score: neutrophil to lymphocyte ratio (OR, 1.27; 95% CI, 1.15–1.39), albumin (OR, 0.76; 95% CI, 0.70–0.83), and chest computed tomography abnormalities (OR, 2.01; 95% CI, 1.41–2.86) and the AUC of the validation cohort was 0.822 (95% CI, 0.7667–0.8776).
Conclusion
This report may help define the potential of developing severe illness in patients with COVID-19 at an early stage, which might be related to the neutrophil to lymphocyte ratio, albumin, and chest computed tomography abnormalities.
