Abstract
This monocentric, retrospective, two-stage observational study aimed to recognize the risk factors for a poor outcome in patients hospitalized with SARS-CoV-2 infection, and to develop and validate a risk score that identifies subjects at risk of worsening, death, or both. The data of patients with SARS-CoV-2 infection during the first wave of the pandemic were collected and analyzed as a derivation cohort. Variables with predictive properties were used to construct a prognostic score, which was tried out on a validation cohort enrolled during the second wave. The derivation cohort included 494 patients; the median age was 62 and the overall fatality rate was 22.3%. In a multivariable analysis, age, oxygen saturation, neutrophil-to-lymphocyte ratio, C-reactive protein and lactate dehydrogenase were independent predictors of death and composed the score. A cutoff value of 3 demonstrated a sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of 93.5%, 68.5%, 47.4% and 97.2% for death, and 84.9%, 84.5%, 79.6% and 87.9% for worsening, respectively. The validation cohort included 415 subjects. The score application showed a Se, Sp, PPV and NPV of 93.4%, 61.6%, 29.5% and 98.1% for death, and 81%, 76.3%, 72.1% and 84.1% for worsening, respectively. We propose a new clinical, easy and reliable score to predict the outcome in hospitalized SARS-CoV-2 patients.
Keywords: COVID-19; SARS-CoV-2; clinical score; prognostic score; risk of death; risk of worsening.
【저자키워드】 COVID-19, SARS-CoV-2, Clinical score, prognostic score, risk of death, risk of worsening., 【초록키워드】 pandemic, Hospitalized, SARS-COV-2 infection, Infection, C-reactive protein, risk, outcome, risk factor, lactate dehydrogenase, Neutrophil-to-lymphocyte ratio, oxygen saturation, sensitivity, specificity, Cohort, Positive predictive value, death, second wave, age, prognostic, First wave, predict, SARS-CoV-2 patients, retrospective, Negative predictive value, Predictive, subject, worsening, multivariable analysis, Fatality rate, validation cohort, cutoff value, variable, enrolled, analyzed, identify, collected, develop, composed, were used, subjects, recognize, demonstrated, independent predictor, NPV, patients hospitalized, patients with SARS-CoV-2, PPV, the median, 【제목키워드】 score, New,