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入院时 COVID-19 的生化严重程度风险评分:Covichem。

Covichem: A biochemical severity risk score of COVID-19 upon hospital admission.

机构信息

Department of Biochemistry, Pellegrin Hospital, University Hospital of Bordeaux, Bordeaux, France.

Inserm U1034, Biology of Cardiovascular Diseases, Pessac, France.

出版信息

PLoS One. 2021 May 6;16(5):e0250956. doi: 10.1371/journal.pone.0250956. eCollection 2021.

Abstract

Clinical and laboratory predictors of COVID-19 severity are now well described and combined to propose mortality or severity scores. However, they all necessitate saturable equipment such as scanners, or procedures difficult to implement such as blood gas measures. To provide an easy and fast COVID-19 severity risk score upon hospital admission, and keeping in mind the above limits, we sought for a scoring system needing limited invasive data such as a simple blood test and co-morbidity assessment by anamnesis. A retrospective study of 303 patients (203 from Bordeaux University hospital and an external independent cohort of 100 patients from Paris Pitié-Salpêtrière hospital) collected clinical and biochemical parameters at admission. Using stepwise model selection by Akaike Information Criterion (AIC), we built the severity score Covichem. Among 26 tested variables, 7: obesity, cardiovascular conditions, plasma sodium, albumin, ferritin, LDH and CK were the independent predictors of severity used in Covichem (accuracy 0.87, AUROC 0.91). Accuracy was 0.92 in the external validation cohort (89% sensitivity and 95% specificity). Covichem score could be useful as a rapid, costless and easy to implement severity assessment tool during acute COVID-19 pandemic waves.

摘要

目前已经很好地描述了 COVID-19 严重程度的临床和实验室预测因素,并将其组合起来提出了死亡率或严重程度评分。然而,它们都需要饱和的设备,如扫描仪,或者难以实施的程序,如血气测量。为了在入院时提供一个简单快捷的 COVID-19 严重程度风险评分,并牢记上述限制,我们寻求一种评分系统,需要有限的侵入性数据,如简单的血液测试和病史评估的合并症。对 303 名患者(203 名来自波尔多大学医院,100 名来自巴黎皮提-萨尔佩特里埃医院的外部独立队列)进行了回顾性研究,收集了入院时的临床和生化参数。使用 Akaike 信息准则(AIC)逐步模型选择,我们构建了严重程度评分 Covichem。在 26 个测试变量中,肥胖、心血管疾病、血浆钠、白蛋白、铁蛋白、乳酸脱氢酶和肌酸激酶是 Covichem 中严重程度的独立预测因素(准确性为 0.87,AUROC 为 0.91)。在外部验证队列中的准确性为 0.92(敏感性为 89%,特异性为 95%)。在急性 COVID-19 大流行期间,Covichem 评分可能是一种快速、免费且易于实施的严重程度评估工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9a8/8101934/f33db3b80d9a/pone.0250956.g001.jpg

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