Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical Collage, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, China.
Department of Neurology, Union Hospital, Tongji Medical Collage, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, China.
BMC Infect Dis. 2020 Dec 17;20(1):960. doi: 10.1186/s12879-020-05561-y.
The mortality rate from acute respiratory distress syndrome (ARDS) is high among hospitalized patients with coronavirus disease 2019 (COVID-19). Hence, risk evaluation tools are required to immediately identify high-risk patients upon admission for early intervention.
A cohort of 220 consecutive patients with COVID-19 were included in this study. To analyze the risk factors of ARDS, data obtained from approximately 70% of the participants were randomly selected and used as training dataset to establish a logistic regression model. Meanwhile, data obtained from the remaining 30% of the participants were used as test dataset to validate the effect of the model.
Lactate dehydrogenase, blood urea nitrogen, D-dimer, procalcitonin, and ferritin levels were included in the risk score system and were assigned a score of 25, 15, 34, 20, and 24, respectively. The cutoff value for the total score was > 35, with a sensitivity of 100.00% and specificity of 81.20%. The area under the receiver operating characteristic curve and the Hosmer-Lemeshow test were 0.967 (95% confidence interval [CI]: 0.925-0.989) and 0.437(P Value = 0.437). The model had excellent discrimination and calibration during internal validation.
The novel risk score may be a valuable risk evaluation tool for screening patients with COVID-19 who are at high risk of ARDS.
住院的 2019 冠状病毒病（COVID-19）患者发生急性呼吸窘迫综合征（ARDS）的死亡率较高。因此，需要风险评估工具来在入院时立即识别高危患者，以便及早干预。
本研究纳入了 220 例连续的 COVID-19 患者。为分析 ARDS 的危险因素，约 70%的参与者的数据被随机抽取并用于建立逻辑回归模型的训练数据集。同时，利用其余 30%的数据作为测试数据集，验证模型的效果。
乳酸脱氢酶、血尿素氮、D-二聚体、降钙素原和铁蛋白水平纳入了风险评分系统，分别赋值为 25、15、34、20 和 24。总分的截断值为>35，其敏感性为 100.00%，特异性为 81.20%。受试者工作特征曲线下面积和 Hosmer-Lemeshow 检验分别为 0.967（95%置信区间：0.925-0.989）和 0.437（P 值=0.437）。该模型在内部验证中具有良好的判别力和校准度。
该新的风险评分可能是一种有价值的风险评估工具，可用于筛选 COVID-19 患者中 ARDS 风险较高的患者。
