Abstract
Background: A novel enveloped RNA beta coronavirus, Corona Virus Disease 2019 (COVID-19) caused severe and even fetal pneumonia in China and other countries from December 2019. Early detection of severe patients with COVID-19 is of great significance to shorten the disease course and reduce mortality.Methods: We assembled a retrospective cohort of 80 patients (including 56 mild and 24 severe) with COVID-19 infection treated at Beijing You'an Hospital. We used univariable and multivariable logistic regression analyses to select the risk factors of severe and even fetal pneumonia and build scoring system for prediction, which was validated later on in a group of 22 COVID-19 patients.Results: Age, white blood cell count, neutrophil, glomerular filtration rate, and myoglobin were selected by multivariate analysis as candidates of scoring system for prediction of disease severity in COVID-19. The scoring system was applied to calculate the predictive value and found that the percentage of ICU admission (20%, 6/30) and ventilation (16.7%, 5/30) in patients with high risk was much higher than those (2%, 1/50; 2%, 1/50) in patients with low risk (p = 0.009; p = 0.026). The AUC of scoring system was 0.906, sensitivity of prediction is 70.8%, and the specificity is 89.3%. According to scoring system, the probability of patients in high risk group developing severe disease was 20.24 times than that in low risk group.Conclusions: The possibility of severity in COVID-19 infection predicted by scoring system could help patients to receiving different therapy strategies at a very early stage.Topic: COVID-19, severe and fetal pneumonia, logistic regression, scoring system, prediction.
Highlights
A cluster of cases of acute respiratory illness with unknown etiology was reported in Wuhan City, Hubei Province of China from December 2019 (Chen et al, 2020)
Age, white blood cell count, neutrophil, glomerular filtration rate, and myoglobin were selected by multivariate analysis as candidates of scoring system for prediction of disease severity in COVID-19
The possibility of severity in COVID-19 infection predicted by scoring system could help patients to receiving different therapy strategies at a very early stage
Summary
A cluster of cases of acute respiratory illness with unknown etiology was reported in Wuhan City, Hubei Province of China from December 2019 (Chen et al, 2020). The pathogen was identified as a novel enveloped RNA beta coronavirus by the Chinese Center for Disease Control and Prevention (CDC) (Wu et al, 2020), and was designated as severe acute respiratory syndrome. According to Coronavirus disease 2019 (COVID-19) situation report from WHO, totally 191,127 cases of patients were laboratory confirmed and amongst them 7,807 patients died by 18th March 2020 (Liu T. et al, 2020; World Health Organization, 2020). This article intends to conduct a group study of 80 patients with COVID-19 infection in a tertiary teaching hospital specializing on infectious diseases to screen for critical factors related to the disease and establish a predictive model for disease severity. A novel enveloped RNA beta coronavirus, Corona Virus Disease 2019 (COVID-19) caused severe and even fetal pneumonia in China and other countries from December 2019. Detection of severe patients with COVID-19 is of great significance to shorten the disease course and reduce mortality
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