Development and Validation of the RCOS Prognostic Index: A Bedside Multivariable Logistic Regression Model to Predict Hypoxaemia or Death in Patients with SARS-CoV-2 Infection.
Journal
Interdisciplinary perspectives on infectious diseases
ISSN: 1687-708X
Titre abrégé: Interdiscip Perspect Infect Dis
Pays: Egypt
ID NLM: 101496545
Informations de publication
Date de publication:
2022
2022
Historique:
received:
22
10
2021
revised:
05
03
2022
accepted:
06
04
2022
entrez:
25
4
2022
pubmed:
26
4
2022
medline:
26
4
2022
Statut:
epublish
Résumé
Previous COVID-19 prognostic models have been developed in hospital settings and are not applicable to COVID-19 cases in the general population. There is an urgent need for prognostic scores aimed to identify patients at high risk of complications at the time of COVID-19 diagnosis. The RDT COVID-19 Observational Study (RCOS) collected clinical data from patients with COVID-19 admitted regardless of the severity of their symptoms in a general hospital in India. We aimed to develop and validate a simple bedside prognostic score to predict the risk of hypoxaemia or death. 4035 patients were included in the development cohort and 2046 in the validation cohort. The primary outcome occurred in 961 (23.8%) and 548 (26.8%) patients in the development and validation cohorts, respectively. The final model included 12 variables: age, systolic blood pressure, heart rate, respiratory rate, aspartate transaminase, lactate dehydrogenase, urea, C-reactive protein, sodium, lymphocyte count, neutrophil count, and neutrophil/lymphocyte ratio. In the validation cohort, the area under the receiver operating characteristic curve (AUROCC) was 0.907 (95% CI, 0.892-0.922), and the Brier Score was 0.098. The decision curve analysis showed good clinical utility in hypothetical scenarios where the admission of patients was decided according to the prognostic index. When the prognostic index was used to predict mortality in the validation cohort, the AUROCC was 0.947 (95% CI, 0.925-0.97) and the Brier score was 0.0188. The RCOS prognostic index could help improve the decision making in the current COVID-19 pandemic, especially in resource-limited settings with poor healthcare infrastructure such as India. However, implementation in other settings is needed to cross-validate and verify our findings.
Identifiants
pubmed: 35464253
doi: 10.1155/2022/2360478
pmc: PMC9020413
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2360478Informations de copyright
Copyright © 2022 Gerardo Alvarez-Uria et al.
Déclaration de conflit d'intérêts
All authors declare no conflicts of interest.
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