F. Hoffmann-La Roche Ltd, Basel, Switzerland.
Max Planck Institute for Intelligent Systems, Tübingen, Germany.
Nat Commun. 2021 Feb 16;12(1):1058. doi: 10.1038/s41467-020-20816-7.
Coronavirus disease 2019 (COVID-19) is a respiratory disease with rapid human-to-human transmission caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Due to the exponential growth of infections, identifying patients with the highest mortality risk early is critical to enable effective intervention and prioritisation of care. Here, we present the COVID-19 early warning system (CovEWS), a risk scoring system for assessing COVID-19 related mortality risk that we developed using data amounting to a total of over 2863 years of observation time from a cohort of 66 430 patients seen at over 69 healthcare institutions. On an external cohort of 5005 patients, CovEWS predicts mortality from 78.8% (95% confidence interval [CI]: 76.0, 84.7%) to 69.4% (95% CI: 57.6, 75.2%) specificity at sensitivities greater than 95% between, respectively, 1 and 192 h prior to mortality events. CovEWS could enable earlier intervention, and may therefore help in preventing or mitigating COVID-19 related mortality.
2019 年冠状病毒病（COVID-19）是一种由严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起的呼吸道疾病，具有快速的人际传播能力。由于感染呈指数级增长，早期识别死亡率最高的患者对于进行有效的干预和优先提供护理至关重要。在这里，我们提出了 COVID-19 早期预警系统（CovEWS），这是一种评估 COVID-19 相关死亡率风险的风险评分系统，我们使用来自 66430 名患者的超过 2863 年的观察时间的数据开发了该系统，这些患者来自 69 家以上的医疗机构。在一个由 5005 名患者组成的外部队列中，CovEWS 在死亡率发生前 1 至 192 小时之间的灵敏度大于 95%时，预测死亡率的特异性分别为 78.8%（95%置信区间[CI]：76.0，84.7%）至 69.4%（95% CI：57.6，75.2%）。CovEWS 可以实现更早的干预，因此可能有助于预防或减轻 COVID-19 相关的死亡率。
