Department of Emergency, The First Medical Center to Chinese People's Liberation Army General Hospital, Beijing, China.
Washington University in St. Louis, St. Louis, USA.
Sci Rep. 2021 Nov 30;11(1):23127. doi: 10.1038/s41598-021-02370-4.
A high-performing interpretable model is proposed to predict the risk of deterioration in coronavirus disease 2019 (COVID-19) patients. The model was developed using a cohort of 3028 patients diagnosed with COVID-19 and exhibiting common clinical symptoms that were internally verified (AUC 0.8517, 95% CI 0.8433, 0.8601). A total of 15 high risk factors for deterioration and their approximate warning ranges were identified. This included prothrombin time (PT), prothrombin activity, lactate dehydrogenase, international normalized ratio, heart rate, body-mass index (BMI), D-dimer, creatine kinase, hematocrit, urine specific gravity, magnesium, globulin, activated partial thromboplastin time, lymphocyte count (L%), and platelet count. Four of these indicators (PT, heart rate, BMI, HCT) and comorbidities were selected for a streamlined combination of indicators to produce faster results. The resulting model showed good predictive performance (AUC 0.7941 95% CI 0.7926, 0.8151). A website for quick pre-screening online was also developed as part of the study.
本研究提出了一种性能良好且可解释的模型,用于预测 2019 冠状病毒病(COVID-19)患者病情恶化的风险。该模型是使用 3028 例经临床诊断为 COVID-19 且表现出常见临床症状的患者队列开发的,在内部得到了验证(AUC 为 0.8517,95%CI 为 0.8433 至 0.8601)。共确定了 15 个与病情恶化相关的高危因素及其大致预警范围,其中包括凝血酶原时间(PT)、凝血酶原活度、乳酸脱氢酶、国际标准化比值、心率、体重指数(BMI)、D-二聚体、肌酸激酶、红细胞压积、尿比重、镁、球蛋白、活化部分凝血活酶时间、淋巴细胞计数(L%)和血小板计数。其中 4 个指标(PT、心率、BMI、HCT)和合并症被选择进行指标的简化组合,以得出更快的结果。该模型具有良好的预测性能(AUC 为 0.7941,95%CI 为 0.7926 至 0.8151)。作为研究的一部分,还开发了一个用于快速在线预筛查的网站。