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奥密克戎 COVID-19 患者蛋白尿风险模型的构建与验证:回顾性队列研究。

Construction and validation of a risk model of proteinuria in patients with omicron COVID-19: retrospective cohort study.

机构信息

Department of Nephrology, Tianjin First Central Hospital, Nankai University, Tianjin, China.

National Health Commission (NHC) Key Laboratory for Critical Care Medicine, Tianjin First Central Hospital, Nankai University, Tianjin, China.

出版信息

Ren Fail. 2024 Dec;46(2):2365979. doi: 10.1080/0886022X.2024.2365979. Epub 2024 Aug 6.

Abstract

BACKGROUND

To explore the risk factors of proteinuria in Omicron variant patients and to construct and verify the risk predictive model.

METHODS

1091 Omicron patients who were hospitalized from August 2022 to November 2022 at Tianjin First Central Hospital were defined as the derivation cohort. 306 Omicron patients who were hospitalized from January 2022 to March 2022 at the same hospital were defined as the validation cohort. The risk factors of proteinuria in derivation cohort were screened by univariate and multivariate logistic regression analysis, and proteinuria predicting scoring system was constructed and the receiver operating characteristic(ROC)curve was drawn to test the prediction ability. The proteinuria risk model was externally validated in validation cohort.

RESULTS

7 factors including comorbidities, blood urea nitrogen (BUN), serum sodium (Na), uric acid (UA), C reactive protein (CRP) and vaccine dosages were included to construct a risk predictive model. The score ranged from -5 to 16. The area under the ROC curve(AUC) of the model was 0.8326(95% CI 0.7816 to 0.8835,  < 0.0001). Similarly to that observed in derivation cohort, the AUC is 0.833(95% CI 0.7808 to 0.9002,  < 0.0001), which verified good prediction ability and diagnostic accuracy in validation cohort.

CONCLUSIONS

The risk model of proteinuria after Omicron infection had better assessing efficiency which could provide reference for clinical prediction of the risk of proteinuria in Omicron patients.

摘要

背景

探索奥密克戎变异株患者蛋白尿的危险因素,并构建和验证风险预测模型。

方法

将 2022 年 8 月至 11 月在天津市第一中心医院住院的 1091 例奥密克戎患者定义为推导队列,将 2022 年 1 月至 3 月在同一医院住院的 306 例奥密克戎患者定义为验证队列。通过单因素和多因素逻辑回归分析筛选推导队列中蛋白尿的危险因素,构建蛋白尿预测评分系统,并绘制受试者工作特征(ROC)曲线以检验预测能力。在验证队列中对蛋白尿风险模型进行外部验证。

结果

共纳入 7 个因素,包括合并症、血尿素氮(BUN)、血清钠(Na)、尿酸(UA)、C 反应蛋白(CRP)和疫苗剂量,构建风险预测模型。评分范围为-5 至 16。模型的 ROC 曲线下面积(AUC)为 0.8326(95%CI 0.7816 至 0.8835,<0.0001)。与推导队列相似,AUC 为 0.833(95%CI 0.7808 至 0.9002,<0.0001),验证了验证队列中良好的预测能力和诊断准确性。

结论

奥密克戎感染后蛋白尿的风险模型具有更好的评估效率,可以为奥密克戎患者蛋白尿风险的临床预测提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4a9/11308959/e25b55893732/IRNF_A_2365979_F0001_C.jpg

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