Dataset Information

Predicting severe or critical symptoms in hospitalized patients with COVID-19 from Yichang, China.

ABSTRACT:

Objectives

We aimed to identify potential risk factors for severe or critical coronavirus disease 2019 (COVID-19) and establish a prediction model based on significant factors.

Methods

A total of 370 patients with COVID-19 were consecutively enrolled at The Third People's Hospital of Yichang from January to March 2020. COVID-19 was diagnosed according to the COVID-19 diagnosis and treatment plan released by the National Health and Health Committee of China. Effect-size estimates are summarized as odds ratio (OR) and 95% confidence interval (CI).

Results

326 patients were diagnosed with mild or ordinary COVID-19, and 44 with severe or critical COVID-19. After propensity score matching and statistical adjustment, eight factors were significantly associated with severe or critical COVID-19 (p <0.05) relative to mild or ordinary COVID-19. Due to strong pairwise correlations, only five factors, including diagnostic delay (OR, 95% CI, p: 1.08, 1.02 to 1.17, 0.048), albumin (0.82, 0.75 to 0.91, <0.001), lactate dehydrogenase (1.56, 1.14 to 2.13, 0.011), white blood cell (1.27, 1.08 to 1.50, 0.004), and neutrophil (1.40, 1.16 to 1.70, <0.001), were retained for model construction and performance assessment. The nomogram model based on the five factors had good prediction capability and accuracy (C-index: 90.6%).

Conclusions

Our findings provide evidence for the significant contribution of five independent factors to the risk of severe or critical COVID-19, and their prediction was reinforced in a nomogram model.

SUBMITTER: Chen X

PROVIDER: S-EPMC7880337 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Predicting severe or critical symptoms in hospitalized patients with COVID-19 from Yichang, China.

Chen Xin X Peng Feng F Zhou Xiaoni X Zhu Jiang J Chen Xin X Gong Yingying Y Shupeng Wang W Niu Wenquan W

Aging 20201209 2

<h4>Objectives</h4>We aimed to identify potential risk factors for severe or critical coronavirus disease 2019 (COVID-19) and establish a prediction model based on significant factors.<h4>Methods</h4>A total of 370 patients with COVID-19 were consecutively enrolled at The Third People's Hospital of Yichang from January to March 2020. COVID-19 was diagnosed according to the COVID-19 diagnosis and treatment plan released by the National Health and Health Committee of China. Effect-size estimates a ...[more]

PMID: 33318316

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Project description:BackgroundCoronavirus disease 2019 (Covid-19) is associated with immune dysregulation and hyperinflammation, including elevated interleukin-6 levels. The use of tocilizumab, a monoclonal antibody against the interleukin-6 receptor, has resulted in better outcomes in patients with severe Covid-19 pneumonia in case reports and retrospective observational cohort studies. Data are needed from randomized, placebo-controlled trials.MethodsIn this phase 3 trial, we randomly assigned patients who were hospitalized with severe Covid-19 pneumonia in a 2:1 ratio receive a single intravenous infusion of tocilizumab (at a dose of 8 mg per kilogram of body weight) or placebo. Approximately one quarter of the participants received a second dose of tocilizumab or placebo 8 to 24 hours after the first dose. The primary outcome was clinical status at day 28 on an ordinal scale ranging from 1 (discharged or ready for discharge) to 7 (death) in the modified intention-to-treat population, which included all the patients who had received at least one dose of tocilizumab or placebo.ResultsOf the 452 patients who underwent randomization, 438 (294 in the tocilizumab group and 144 in the placebo group) were included in the primary and secondary analyses. The median value for clinical status on the ordinal scale at day 28 was 1.0 (95% confidence interval [CI], 1.0 to 1.0) in the tocilizumab group and 2.0 (non-ICU hospitalization without supplemental oxygen) (95% CI, 1.0 to 4.0) in the placebo group (between-group difference, -1.0; 95% CI, -2.5 to 0; P = 0.31 by the van Elteren test). In the safety population, serious adverse events occurred in 103 of 295 patients (34.9%) in the tocilizumab group and in 55 of 143 patients (38.5%) in the placebo group. Mortality at day 28 was 19.7% in the tocilizumab group and 19.4% in the placebo group (weighted difference, 0.3 percentage points; 95% CI, -7.6 to 8.2; nominal P = 0.94).ConclusionsIn this randomized trial involving hospitalized patients with severe Covid-19 pneumonia, the use of tocilizumab did not result in significantly better clinical status or lower mortality than placebo at 28 days. (Funded by F. Hoffmann-La Roche and the Department of Health and Human Services; COVACTA ClinicalTrials.gov number, NCT04320615.).

Dataset Information

Predicting severe or critical symptoms in hospitalized patients with COVID-19 from Yichang, China.

Objectives

Methods

Results

Conclusions

Publications

Predicting severe or critical symptoms in hospitalized patients with COVID-19 from Yichang, China.

Similar Datasets

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