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Biomed Environ Sci . Factors Defining the Development of Severe Illness in Patients with COVID-19: A Retrospective Study

tetano

Editor, Senior Moderator
Biomed Environ Sci


. 2021 Dec 20;34(12):984-991.
doi: 10.3967/bes2021.117.
Factors Defining the Development of Severe Illness in Patients with COVID-19: A Retrospective Study


Yi Bai Xiong[SUP] 1 [/SUP], Ya Xin Tian[SUP] 1 [/SUP], Yan Ma[SUP] 1 [/SUP], Wei Yang[SUP] 1 [/SUP], Bin Liu[SUP] 1 [/SUP], Lian Guo Ruan[SUP] 2 [/SUP], Cheng Lu[SUP] 1 [/SUP], Lu Qi Huang[SUP] 3 [/SUP]



Affiliations

Abstract

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.

Keywords: COVID-19; Nomogram; Risk factors; Severe illness.
 
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