Cao Guodong, Li Pengping, Chen Yuanyuan, Fang Kun, Chen Bo, Wang Shuyue, Feng Xudong, Wang Zhenyu, Xiong Maoming, Zheng Ruiying, Guo Mengzhe, Sun Qiang
School of Medicine, Zhejiang University, Hangzhou, China.
The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Front Med (Lausanne). 2020 Nov 5;7:556886. doi: 10.3389/fmed.2020.556886. eCollection 2020.
The epidemic of coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has expanded from China throughout the world. This study aims to estimate the risk of disease progression of patients who have been confirmed with COVID-19. Meta-analysis was performed in existing literatures to identify risk factors associated with COVID-19 pneumonia progression. Patients with COVID-19 pneumonia were admitted to hospitals in Wuhan or Hangzhou were retrospectively enrolled. The risk prediction model and nomogram were developed from Wuhan cohort through logistic regression algorithm, and then validated in Hangzhou and Yinchuan cohorts. A total of 270 patients admitted to hospital between Dec 30, 2019, and Mar 30, 2020, were retrospectively enrolled (Table 1). The development cohort (Wuhan cohort) included 87 (43%) men and 115 (57%) women, and the median age was 53 years old. Hangzhou validation cohort included 20 (48%) men and 22 (52%) women, and the median age was 59 years old. Yinchuan validation cohort included 12 (46%) men and 14 (54%) women, and the median age was 44 years old. The meta-analysis along with univariate logistic analysis in development cohort have shown that age, fever, diabetes, hypertension, CREA, BUN, CK, LDH, and neutrophil count were significantly associated with disease progression of COVID-19 pneumonia. The model and nomogram derived from development cohort show good performance in both development and validation cohorts. The severe COVID-19 pneumonia is associated with various types of risk factors including age, fever, comorbidities, and some laboratory examination indexes. The model integrated with these factors can help to evaluate the disease progression of COVID-19 pneumonia.
由严重急性呼吸综合征冠状病毒2(SARS-CoV2)感染引起的2019冠状病毒病(COVID-19)肺炎疫情已从中国蔓延至全球。本研究旨在评估COVID-19确诊患者的疾病进展风险。对现有文献进行荟萃分析,以确定与COVID-19肺炎进展相关的危险因素。回顾性纳入了在武汉或杭州住院的COVID-19肺炎患者。通过逻辑回归算法从武汉队列中建立风险预测模型和列线图,然后在杭州和银川队列中进行验证。共回顾性纳入了2019年12月30日至2020年3月30日期间住院的270例患者(表1)。开发队列(武汉队列)包括87名(43%)男性和115名(57%)女性,中位年龄为53岁。杭州验证队列包括20名(48%)男性和22名(52%)女性,中位年龄为59岁。银川验证队列包括12名(46%)男性和14名(54%)女性,中位年龄为44岁。开发队列中的荟萃分析以及单因素逻辑分析表明,年龄、发热、糖尿病、高血压、肌酐、尿素氮、肌酸激酶、乳酸脱氢酶和中性粒细胞计数与COVID-19肺炎的疾病进展显著相关。从开发队列得出的模型和列线图在开发队列和验证队列中均表现良好。严重COVID-19肺炎与多种类型的危险因素相关,包括年龄、发热、合并症和一些实验室检查指标。整合这些因素的模型有助于评估COVID-19肺炎的疾病进展。