Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Clinical Laboratory, Xixi Hospital of Hangzhou, Hangzhou, China.
Clin Chim Acta. 2021 Jan;512:49-57. doi: 10.1016/j.cca.2020.11.019. Epub 2020 Dec 3.
Majority coronavirus disease 2019 (COVID-19) patients are classified as mild and moderate (non-severe) diseases. We aim to develop a model to predict isolation length for non-severe patients.
Among 188 non-severe patients, 96 patients were enrolled as training cohort to identify factors associated with isolation length via Cox regression model and develop a nomogram. Other 92 patients formed as validation cohort to validate nomogram. Concordance index (C-index), area under the curve (AUC) and calibration curves were used to evaluated nomogram.
Increasing absolute eosinophil count (AEC) after admission was correlated with shorter isolation length (P = 0.02). Baseline activated partial thromboplastin time (APTT) > 30 s was correlated with longer isolation length (P = 0.03). A nomogram to predict isolation probability at 11-, 16- and 21-day was developed and validated. The C-indices of training and validation cohort were 0.604 and 0.682 respectively. Both cohorts showed a good discriminative ability (AUC, 11-day: 0.646 vs 0.730; 16-day: 0.663 vs 0.750; 21-day: 0.711 vs 0.783; respectively) and calibration power.
Baseline APTT and dynamic change of AEC were two significant factors associated with isolation length of non-severe patients. Nomogram could predict isolation probability for each patient to estimate appropriate quarantine length.
大多数新型冠状病毒疾病 2019(COVID-19)患者被归类为轻症和中度(非重症)疾病。我们旨在开发一种模型来预测非重症患者的隔离时间。
在 188 名非重症患者中,96 名患者被纳入训练队列,通过 Cox 回归模型确定与隔离时间相关的因素,并制定列线图。其他 92 名患者作为验证队列,验证列线图。使用一致性指数(C-index)、曲线下面积(AUC)和校准曲线来评估列线图。
入院后绝对嗜酸性粒细胞计数(AEC)的增加与较短的隔离时间相关(P=0.02)。基线部分凝血活酶时间(APTT)>30s 与较长的隔离时间相关(P=0.03)。开发并验证了预测 11、16 和 21 天隔离概率的列线图。训练和验证队列的 C 指数分别为 0.604 和 0.682。两个队列均表现出良好的区分能力(AUC,11 天:0.646 与 0.730;16 天:0.663 与 0.750;21 天:0.711 与 0.783;分别)和校准能力。
基线 APTT 和 AEC 的动态变化是与非重症患者隔离时间相关的两个重要因素。列线图可以预测每位患者的隔离概率,以估计适当的隔离时间。