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Clinical and Laboratory Predictors of In-hospital Mortality in Patients With Coronavirus Disease-2019: A Cohort Study in Wuhan, China

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单位: [1]Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Geriatr, Wuhan, Peoples R China [2]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Geriatr, Wuhan, Peoples R China [3]Wuhan Univ, Zhongnan Hosp, Dept Gen Practice, Wuhan, Hubei, Peoples R China [4]X&Y Solut Inc, Dept Epidemiol & Biostat, EmpowerU, Boston, MA USA [5]First Peoples Hosp Jiangxia Dist, Wuhan, Peoples R China [6]HUST, Union Jiangnan Hosp, Wuhan, Peoples R China
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关键词: COVID-19 predictive model mortality

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Background. This study aimed to develop mortality-prediction models for patients with coronavirus disease-2019 (COVID-19). Methods. The training cohort included consecutive COVID-19 patients at the First People's Hospital of Jiangxia District in Wuhan, China, from 7 January 2020 to 11 February 2020. We selected baseline data through the stepwise Akaike information criterion and ensemble XGBoost (extreme gradient boosting) model to build mortality-prediction models. We then validated these models by randomly collected COVID-19 patients in Union Hospital, Wuhan, from 1 January 2020 to 20 February 2020. Results. A total of 296 COVID-19 patients were enrolled in the training cohort; 19 died during hospitalization and 277 discharged from the hospital. The clinical model developed using age, history of hypertension, and coronary heart disease showed area under the curve (AUC), 0.88 (95% confidence interval [CI], .80-.95); threshold, -2.6551; sensitivity, 92.31%; specificity, 77.44%; and negative predictive value (NPV), 99.34%. The laboratory model developed using age, high-sensitivity C-reactive protein, peripheral capillary oxygen saturation, neutrophil and lymphocyte count, D-dimer, aspartate aminotransferase, and glomerular filtration rate had a significantly stronger discriminatory power than the clinical model (P = .0157), with AUC, 0.98 (95% CI, .92-.99); threshold, -2.998; sensitivity, 100.00%; specificity, 92.82%; and NPV, 100.00%. In the subsequent validation cohort (N = 44), the AUC (95% CI) was 0.83 (.68-.93) and 0.88 (.75-.96) for the clinical model and laboratory model, respectively. Conclusions. We developed 2 predictive models for the in-hospital mortality of patients with COVID-19 in Wuhan that were validated in patients from another center.

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出版当年[2019]版:
大类 | 1 区 医学
小类 | 1 区 免疫学 1 区 传染病学 1 区 微生物学
最新[2025]版:
大类 | 2 区 医学
小类 | 1 区 传染病学 1 区 微生物学 2 区 免疫学
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出版当年[2018]版:
Q1 INFECTIOUS DISEASES Q1 MICROBIOLOGY Q1 IMMUNOLOGY
最新[2023]版:
Q1 IMMUNOLOGY Q1 INFECTIOUS DISEASES Q1 MICROBIOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2018版] 出版当年五年平均 出版前一年[2017版] 出版后一年[2019版]

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第一作者单位: [1]Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Geriatr, Wuhan, Peoples R China
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通讯机构: [1]Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Geriatr, Wuhan, Peoples R China [5]First Peoples Hosp Jiangxia Dist, Wuhan, Peoples R China [6]HUST, Union Jiangnan Hosp, Wuhan, Peoples R China
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