A biomarker based severity progression indicator for COVID-19: the Kuwait prognosis indicator score
A biomarker based severity progression indicator for COVID-19: the Kuwait prognosis indicator score
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DOI：
10.1080/1354750x.2020.1841296
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发表时间：
2020-11-03
期刊：
影响因子：
2.6
通讯作者：
Al-Sabah, Salman
中科院分区：
文献类型：
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作者：
Jamal, Mohammad H.;Doi, Suhail A.;Al-Sabah, Salman
背景COVID-19是一种世界性大流行，对大多数患者来说是轻微的，但可导致肺炎样疾病，进展为急性呼吸窘迫综合征和死亡。预测诊断时的疾病严重程度有助于确定入院和资源的优先顺序。方法我们在2020年2月24日至4月20日期间前瞻性地招募了1096名连续入选的患者，其中643名符合新冠肺炎纳入标准，贾比尔医院是一家位于科威特的新冠肺炎设施。感兴趣的主要终点是通过算法定义的疾病严重性。在基于聚合酶链式反应的感染诊断时收集预定义的风险变量。预后模型的建立采用了5次交叉验证的正则化Logit回归。结果有643例患者有临床病程资料，其中94例发生严重新冠肺炎。在最终的模型中，年龄、C反应蛋白、降钙素原、淋巴细胞百分比、单核细胞百分比和血清白蛋白是更严重病程的独立预测因素。最终的预后模型显示出了良好的区分性，并且区分性和校准性都得到了外部数据集的确认。结论我们开发并验证了一个在诊断时计算的简单评分，该评分可以可靠地预测重症新冠肺炎病患者，并已得到外部验证。KPI分数计算器现在可以在covidkScott网站上在线获得
BackgroundCOVID-19 is a worldwide pandemic that is mild in most patients but can result in a pneumonia like illness with progression to acute respiratory distress syndrome and death. Predicting the disease severity at time of diagnosis can be helpful in prioritizing hospital admission and resources.MethodsWe prospectively recruited 1096 consecutive patients of whom 643 met the inclusion criterion with COVID-19 from Jaber Hospital, a COVID-19 facility in Kuwait, between 24 February and 20 April 2020. The primary endpoint of interest was disease severity defined algorithmically. Predefined risk variables were collected at the time of PCR based diagnosis of the infection. Prognostic model development used 5-fold cross-validated regularized logit regression. The model was externally validated against data from Wuhan, China.ResultsThere were 643 patients with clinical course data of whom 94 developed severe COVID-19. In the final model, age, CRP, procalcitonin, lymphocyte percentage, monocyte percentages and serum albumin were independent predictors of a more severe illness course. The final prognostic model demonstrated good discrimination, and both discrimination and calibration were confirmed with an external dataset.ConclusionWe developed and validated a simple score calculated at time of diagnosis that can predict patients with severe COVID-19 disease reliably and that has been validated externally. The KPI score calculator is now available online at covidkscore.com