Abstract
The outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread to become a worldwide emergency. Early identification of patients at risk of progression may facilitate more individually aligned treatment plans and optimized utilization of medical resource. Here we conducted a multicenter retrospective study involving patients with moderate COVID-19 pneumonia to investigate the utility of chest computed tomography (CT) and clinical characteristics to risk-stratify the patients. Our results show that CT severity score is associated with inflammatory levels and that older age, higher neutrophil-to-lymphocyte ratio (NLR), and CT severity score on admission are independent risk factors for short-term progression. The nomogram based on these risk factors shows good calibration and discrimination in the derivation and validation cohorts. These findings have implications for predicting the progression risk of COVID-19 pneumonia patients at the time of admission. CT examination may help risk-stratification and guide the timing of admission.
Highlights
The outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread to become a worldwide emergency
Several studies reported that the prevalence of severe COVID-19 ranged from 15.7 to 26.1% among patients admitted to hospital and these cases were often associated with abnormal chest computed tomography (CT) findings and clinical laboratory data[6,7,8]
Our results indicated that CT severity score was associated with inflammatory levels, and older age, higher neutrophil-to-lymphocyte ratio (NLR) and CT severity score on admission were independent predictors for progression to severe COVID-19 pneumonia
Summary
The outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread to become a worldwide emergency. The nomogram based on these risk factors shows good calibration and discrimination in the derivation and validation cohorts These findings have implications for predicting the progression risk of COVID-19 pneumonia patients at the time of admission. Guan et al indicated that severe COVID-19 patients were more likely to show ground-glass opacity (GGO), local or bilateral patchy shadowing, and interstitial abnormalities on CT8 This likely reflects the clinical progression of disease and offers an opportunity to investigate the clinical utility of chest CT as a predictive tool to risk-stratify the patients. We show a nomogram incorporating age, neutrophil-tolymphocyte ratio (NLR), and CT severity score on admission with good performance in the prediction of short-term disease progression in hospitalized patients with moderate COVID-19 pneumonia, which have implications for early predicting the progression risk and guiding individually aligned treatment plans among COVID-19 pneumonia patients
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