An integrated clinical and genetic model for predicting risk of severe COVID-19: A population-based case-control study.
An integrated clinical and genetic model for predicting risk of severe COVID-19: A population-based case-control study.
复制标题
DOI：
10.1371/journal.pone.0247205
复制
发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Allman R
中科院分区：
文献类型：
--
作者：
Dite GS;Murphy NM;Allman R
高达30%的SARS-CoV-2检测呈阳性的人将发展为严重的COVID-19并需要住院治疗。已知年龄、性别和合并症是严重COVID-19的风险因素，但通常在没有准确了解其对风险影响程度的情况下独立考虑，可能导致错误的风险估计。迫切需要准确预测严重COVID-19的风险，以用于工作场所和医疗环境，以及个人风险管理。临床危险因素和一组64个单核苷酸多态性从已发表的数据中确定。我们使用逻辑回归在1，582名年龄在50岁及以上的英国生物银行参与者中开发了严重COVID-19模型，这些参与者对SARS-CoV-2病毒检测呈阳性：1，018名患有严重疾病，564名没有严重疾病。使用受试者工作特征曲线下面积（AUC）评估模型区分度。结合SNP评分和临床风险因素的模型（AUC = 0.786; 95%置信区间= 0.763至0.808）比仅含年龄和性别的模型（AUC = 0.635; 95%置信区间= 0.607至0.662）对疾病严重程度的区分好111%。年龄和性别的影响被其他风险因素削弱，这表明是这些风险因素而不是年龄和性别赋予严重疾病的风险。在整个英国生物库中，大多数人的风险较低或仅略高，但三分之一的风险增加了两倍或更多。我们开发了一个模型，可以准确预测严重的COVID-19。继续仅依赖年龄和性别（或仅依赖临床因素）来确定严重COVID-19的风险，将不必要地将健康的老年人归类为高风险人群，并且无法准确量化患有合并症的年轻人的风险增加。
Up to 30% of people who test positive to SARS-CoV-2 will develop severe COVID-19 and require hospitalisation. Age, gender, and comorbidities are known to be risk factors for severe COVID-19 but are generally considered independently without accurate knowledge of the magnitude of their effect on risk, potentially resulting in incorrect risk estimation. There is an urgent need for accurate prediction of the risk of severe COVID-19 for use in workplaces and healthcare settings, and for individual risk management. Clinical risk factors and a panel of 64 single-nucleotide polymorphisms were identified from published data. We used logistic regression to develop a model for severe COVID-19 in 1,582 UK Biobank participants aged 50 years and over who tested positive for the SARS-CoV-2 virus: 1,018 with severe disease and 564 without severe disease. Model discrimination was assessed using the area under the receiver operating characteristic curve (AUC). A model incorporating the SNP score and clinical risk factors (AUC = 0.786; 95% confidence interval = 0.763 to 0.808) had 111% better discrimination of disease severity than a model with just age and gender (AUC = 0.635; 95% confidence interval = 0.607 to 0.662). The effects of age and gender are attenuated by the other risk factors, suggesting that it is those risk factors–not age and gender–that confer risk of severe disease. In the whole UK Biobank, most are at low or only slightly elevated risk, but one-third are at two-fold or more increased risk. We have developed a model that enables accurate prediction of severe COVID-19. Continuing to rely on age and gender alone (or only clinical factors) to determine risk of severe COVID-19 will unnecessarily classify healthy older people as being at high risk and will fail to accurately quantify the increased risk for younger people with comorbidities.
登录
查看更多内容
影响因子：
4.5
作者：
Melzer D;Perry JR;Hernandez D;Corsi AM;Stevens K;Rafferty I;Lauretani F;Murray A;Gibbs JR;Paolisso G;Rafiq S;Simon-Sanchez J;Lango H;Scholz S;Weedon MN;Arepalli S;Rice N;Washecka N;Hurst A;Britton A;Henley W;van de Leemput J;Li R;Newman AB;Tranah G;Harris T;Panicker V;Dayan C;Bennett A;McCarthy MI;Ruokonen A;Jarvelin MR;Guralnik J;Bandinelli S;Frayling TM;Singleton A;Ferrucci L
通讯作者：
Ferrucci L
影响因子：
64.8
作者：
Bycroft C;Freeman C;Petkova D;Band G;Elliott LT;Sharp K;Motyer A;Vukcevic D;Delaneau O;O'Connell J;Cortes A;Welsh S;Young A;Effingham M;McVean G;Leslie S;Allen N;Donnelly P;Marchini J
通讯作者：
Marchini J
DOI：
10.1093/jnci/djq388
发表时间：
2010-11-03
期刊：
Journal of the National Cancer Institute
影响因子：
--
作者：
Mealiffe ME;Stokowski RP;Rhees BK;Prentice RL;Pettinger M;Hinds DA
通讯作者：
Hinds DA
影响因子：
14.9
作者：
Dayem Ullah AZ;Oscanoa J;Wang J;Nagano A;Lemoine NR;Chelala C
通讯作者：
Chelala C
影响因子：
11.2
作者：
Wolpin BM;Kraft P;Gross M;Helzlsouer K;Bueno-de-Mesquita HB;Steplowski E;Stolzenberg-Solomon RZ;Arslan AA;Jacobs EJ;Lacroix A;Petersen G;Zheng W;Albanes D;Allen NE;Amundadottir L;Anderson G;Boutron-Ruault MC;Buring JE;Canzian F;Chanock SJ;Clipp S;Gaziano JM;Giovannucci EL;Hallmans G;Hankinson SE;Hoover RN;Hunter DJ;Hutchinson A;Jacobs K;Kooperberg C;Lynch SM;Mendelsohn JB;Michaud DS;Overvad K;Patel AV;Rajkovic A;Sanchéz MJ;Shu XO;Slimani N;Thomas G;Tobias GS;Trichopoulos D;Vineis P;Virtamo J;Wactawski-Wende J;Yu K;Zeleniuch-Jacquotte A;Hartge P;Fuchs CS
通讯作者：
Fuchs CS