Yu Xiaoqian, Wang Liling, Zhang Chengzhen, Zhao Xueqiang
Hospital of Shandong Technology and Business University, Yantai, China.
Department of Pediatrics, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.
Medicine (Baltimore). 2025 Jun 27;104(26):e43142. doi: 10.1097/MD.0000000000043142.
Novel coronavirus pneumonia (COVID-19) poses a major threat to human health as a global public health problem. Currently, the morbidity and mortality rate of myocardial injury in COVID-19 patients is as high as 59.6%; however, clinical prediction models for myocardial injury in COVID-19 patients are not well developed. This study used a retrospective analysis to include 1737 COVID-19 patients who attended Thousand Buddha Mountain Hospital in Shandong Province from December 2022 to December 2023. Data collection was performed through a medical big data system, and the patients were randomly divided into a training group (1216 cases) and a validation group (521 cases). In this study, 1-factor logistic regression, optimal subset regression, and least absolute shrinkage and selection operator regression were used to screen risk factors for myocardial infarction, and a prediction model was constructed based on the results of multifactor logistic regression. The predictive efficacy and clinical utility of the model were further evaluated using area under the receiver operating characteristic curve, calibration curve, and decision curve analysis. (1) Predictor variables screened by one-way logistic regression, optimal subset regression, and least absolute shrinkage and selection operator regression were included in multifactorial logistic regression, respectively, and the results all showed that age, history of alcohol consumption, diastolic blood pressure, heart rate, body mass index, and cystatin C were important risk factors affecting the occurrence of myocardial injury in patients with new crowns. (2) receiver operating characteristic curves were drawn based on the risk factors screened and the results showed that the area under the curve for the prediction set was 0.78 (0.75-0.81). (3) The calibration curves show that the model has good accuracy, with a mean error of 0.02 for both the training set as well as the validation set models. In this study, a myocardial injury prediction model for COVID-19 patients based on clinical parameters was successfully constructed used age, history of alcohol consumption, diastolic blood pressure, heart rate, body mass index, and cystatin C.
新型冠状病毒肺炎(COVID-19)作为一个全球公共卫生问题,对人类健康构成了重大威胁。目前,COVID-19患者心肌损伤的发病率和死亡率高达59.6%;然而,针对COVID-19患者心肌损伤的临床预测模型尚未得到充分发展。本研究采用回顾性分析方法,纳入了2022年12月至2023年12月在山东省千佛山医院就诊的1737例COVID-19患者。通过医疗大数据系统进行数据收集,并将患者随机分为训练组(1216例)和验证组(521例)。在本研究中,使用单因素逻辑回归、最优子集回归和最小绝对收缩和选择算子回归来筛选心肌梗死的危险因素,并基于多因素逻辑回归结果构建预测模型。使用受试者操作特征曲线下面积、校准曲线和决策曲线分析进一步评估该模型的预测效能和临床实用性。(1)将通过单因素逻辑回归、最优子集回归和最小绝对收缩和选择算子回归筛选出的预测变量分别纳入多因素逻辑回归,结果均显示年龄、饮酒史、舒张压、心率、体重指数和胱抑素C是影响新冠患者心肌损伤发生的重要危险因素。(2)基于筛选出的危险因素绘制受试者操作特征曲线,结果显示预测集的曲线下面积为0.78(0.75-0.81)。(3)校准曲线表明该模型具有良好的准确性,训练集和验证集模型的平均误差均为0.02。在本研究中,成功构建了一个基于临床参数的COVID-19患者心肌损伤预测模型,该模型使用年龄、饮酒史、舒张压、心率、体重指数和胱抑素C。