Wang Zhi, Zhong Bin-Yan, Dai Hui, Xu Qiu-Zhen, Yang Wei-Bin, Zhang Xin, Xu Chuan-Jun, Shu Jin-Er, Shi Biao, Zeng Chu-Hui, Li Cheng, Ji Jian-Song, Li Yong-Gang, Teng Gao-Jun
Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu Province 210009, China.
Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province 215006, China.
Fundam Res. 2021 Mar;1(2):111-116. doi: 10.1016/j.fmre.2021.01.012. Epub 2021 Jan 26.
The present study aimed to establish a prognostic nomogram to stratify high-risk patients with Coronavirus Disease 2019 (COVID-19) who progressed from the nonsevere condition on admission to severe during hospitalization. This multicenter retrospective study included patients with nonsevere COVID-19 on admission from Jan 10, 2020 to Feb 7, 2020. In the training cohort, independent risk factors associated with disease progression were identified by univariate and multivariate analyses. The prognostic nomogram was established and then validated externally using C-index. The study included 351 patients (293 and 58 in the training and validation cohorts, respectively), with 27 (9.2%) and 5 (8.6%) patients progressed, respectively. In the training cohort, older age (OR 1.036, 95% CI 1.000-1.073), more lobes involved on chest CT (OR 1.841, 95% CI 1.117-3.035), comorbidity present (OR 2.478, 95% CI 1.020-6.018), and lower lymphocyte count (OR 0.081, 95% CI 0.019-0.349) were identified as independent risk factors. The prognostic nomogram was established in the training cohort with satisfied external prognostic performance (C-index 0.906, 95% CI 0.806-1.000). In conclusion, older age, comorbidity present, more lobes involved on chest CT, and lower lymphocyte count are independent risk factors associated with disease progression during hospitalization for patients with nonsevere COVID-19.
本研究旨在建立一种预后列线图，以对2019冠状病毒病（COVID-19）高危患者进行分层，这些患者入院时为非重症，但在住院期间进展为重症。这项多中心回顾性研究纳入了2020年1月10日至2020年2月7日入院的非重症COVID-19患者。在训练队列中，通过单因素和多因素分析确定了与疾病进展相关的独立危险因素。建立了预后列线图，然后使用C指数进行外部验证。该研究共纳入351例患者（训练队列和验证队列分别为293例和58例），分别有27例（9.2%）和5例（8.6%）患者病情进展。在训练队列中，年龄较大（OR 1.036，95%CI 1.000-1.073）、胸部CT显示更多肺叶受累（OR 1.841，95%CI 1.117-3.035）、存在合并症（OR 2.478，95%CI 1.020-6.018）以及淋巴细胞计数较低（OR 0.081，95%CI 0.019-0.349）被确定为独立危险因素。在训练队列中建立了预后列线图，其具有满意的外部预后性能（C指数0.906，95%CI 0.806-1.000）。总之，年龄较大、存在合并症、胸部CT显示更多肺叶受累以及淋巴细胞计数较低是入院时非重症COVID-19患者住院期间疾病进展的独立危险因素。
