This study aims to screen useful predictors of critical cases among coronavirus disease 2019 (COVID-19) patients and to develop a simple-to-use nomogram for clinical utility. A retrospective study was conducted that consisted of a primary cohort with 315 COVID-19 patients and two validation cohorts with 69 and 123 patients, respectively. Logistic regression analyses were used to identify the independent risks of progression to critical. An individualized prediction model was developed, and calibration, decision curve, and clinical impact curves were used to assess the performance of the model. External validations for the predictive nomogram were also provided. The variables of age, comorbid diseases, neutrophil-to-lymphocyte ratio,d-dimer, C-reactive protein, and platelet count were estimated to be independent predictors of progression to critical, which were incorporated to establish a model of the nomogram. It demonstrated good discrimination (with a C-index of 0.923) and calibration. Good discrimination (C-index, 0.882 and 0.906) and calibration were also noted on applying the nomogram in two validation cohorts. The clinical relevance of the nomogram was justified by the decision curve and clinical impact curve analysis. This study presents an individualized prediction nomogram incorporating six clinical characteristics, which can be conveniently applied to assess an individual's risk of progressing to critical COVID-19.
基金:
National Natural Science Foundation of P.R. China [81800609]; Second batch of COVID-19 prevention and control projects in Xinxiang [20GG008]; HUST COVID-19 Rapid Response Call [2020kfyXGYJ015]
第一作者单位:[1]Huazhong Univ Sci & Technol,Tongji Hosp,Dept Nephrol,Tongji Med Coll,1095 Jiefang Ave,Wuhan 430030,Hubei,Peoples R China
通讯作者:
通讯机构:[1]Huazhong Univ Sci & Technol,Tongji Hosp,Dept Nephrol,Tongji Med Coll,1095 Jiefang Ave,Wuhan 430030,Hubei,Peoples R China[3]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Hlth Management Ctr,Wuhan,Hubei,Peoples R China
推荐引用方式(GB/T 7714):
Xu Ranran,Cui Junwei,Hu Liu,et al.Development and validation of a simplified nomogram predicting individual critical illness of risk in COVID-19: A retrospective study[J].JOURNAL OF MEDICAL VIROLOGY.2021,93(4):1999-2009.doi:10.1002/jmv.26551.
APA:
Xu, Ranran,Cui, Junwei,Hu, Liu,Wang, Yiru,Wang, Tao...&Liu, Qingquan.(2021).Development and validation of a simplified nomogram predicting individual critical illness of risk in COVID-19: A retrospective study.JOURNAL OF MEDICAL VIROLOGY,93,(4)
MLA:
Xu, Ranran,et al."Development and validation of a simplified nomogram predicting individual critical illness of risk in COVID-19: A retrospective study".JOURNAL OF MEDICAL VIROLOGY 93..4(2021):1999-2009