Abstract
Objectives: We compared and validated the performance accuracy of simplified comorbidity evaluation compared to the Charlson Comorbidity Index (CCI) predicting COVID-19 severity. In addition, we also determined whether risk prediction of COVID-19 severity changed during different COVID-19 pandemic outbreaks.
Methods: We enrolled all patients whose SARS-CoV-2 PCR tests were performed at six different hospital Emergency Departments in 2020. Patients were divided into three groups based on the various COVID-19 outbreaks in the US (first wave: March-May 2020, second wave: June-September 2020, and third wave: October-December 2020). A simplified comorbidity evaluation was used as an independent risk factor to predict clinical outcomes using multivariate logistic regressions.
Results: A total of 22,248 patients were included, for which 7023 (32%) patients tested COVID-19 positive. Higher percentages of COVID-19 patients with more than three chronic conditions had worse clinical outcomes (i.e., hospital and intensive care unit admissions, receiving invasive mechanical ventilations, and in-hospital mortality) during all three COVID-19 outbreak waves.
Conclusions: This simplified comorbidity evaluation was validated to be associated with COVID clinical outcomes. Such evaluation did not perform worse when compared with CCI to predict in-hospital mortality.
Keywords: COVID-19; Clinical outcomes; Comorbidity; Pandemic outbreaks.
【저자키워드】 COVID-19, Comorbidity, clinical outcomes, Pandemic outbreaks., 【초록키워드】 intensive care, COVID-19 pandemic, hospital, COVID-19 severity, risk, Clinical outcome, COVID, Outbreaks, COVID-19 outbreak, Accuracy, clinical, Patient, chronic condition, predict, in-hospital mortality, Emergency, COVID-19 patient, Admissions, Charlson Comorbidity Index, independent risk factor, Department, positive, SARS-CoV-2 PCR test, logistic regressions, enrolled, tested, performed, was used, addition, receiving, changed, three group, CCI, invasive mechanical, percentage, 【제목키워드】 coronavirus disease, Clinical outcome, validation, Patient, multicenter, retrospective, observation,