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Development and validation of a risk score using complete blood count to predict in-hospital mortality in COVID-19 patients.

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机构： [1]Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China. [2]Department of Gastroenterology, Wuhan Third Hospital & Tongren Hospital of Wuhan University, Wuhan, China. [3]Institute of Model Animal, Wuhan University, Wuhan, China. [4]School of Mathematics and Physics, Wuhan Institute of Technology, Wuhan, China. [5]Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China. [6]Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China. [7]The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China. [8]Centre for Clinic Pharmacology, the William Harvey Research Institute, Queen Mary University of London, London, UK. [9]Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA 19004, USA. [10]Department of Cardiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [11]Humanitas Clinical and Research Hospital IRCCS, Rozzano-Milan, Italy. [12]Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy. [13]Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [14]Department of Neonatology, Renmin Hospital of Wuhan University, Wuhan, China. [15]Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan. [16]Department of Anesthesiology, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA. [17]Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China.

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To develop a sensitive risk score predicting the risk of mortality in patients with coronavirus disease 2019 (COVID-19) using complete blood count (CBC). We performed a retrospective cohort study from a total of 13,138 inpatients with COVID-19 in Hubei, China, and Milan, Italy. Among them, 9,810 patients with ≥2 CBC records from Hubei were assigned to the training cohort. CBC parameters were analyzed as potential predictors for all-cause mortality and were selected by the generalized linear mixed model (GLMM). Five risk factors were derived to construct a composite score (PAWNN score) using the Cox regression model, including platelet counts, age, white blood cell counts, neutrophil counts, and neutrophil:lymphocyte ratio. The PAWNN score showed good accuracy for predicting mortality in 10-fold cross-validation (AUROCs 0.92-0.93) and subsets with different quartile intervals of follow-up and preexisting diseases. The performance of the score was further validated in 2,949 patients with only 1 CBC record from the Hubei cohort (AUROC 0.97) and 227 patients from the Italian cohort (AUROC 0.80). The latent Markov model (LMM) demonstrated that the PAWNN score has good prediction power for transition probabilities between different latent conditions. The PAWNN score is a simple and accurate risk assessment tool that can predict the mortality for COVID-19 patients during their entire hospitalization. This tool can assist clinicians in prioritizing medical treatment of COVID-19 patients. This work was supported by National Key R&D Program of China (2016YFF0101504, 2016YFF0101505, 2020YFC2004702, 2020YFC0845500), the Key R&D Program of Guangdong Province (2020B1111330003), and the medical flight plan of Wuhan University (TFJH2018006). © 2020 Elsevier Inc.

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大类 | 1 区

医学

小类 | 1 区医学：研究与实验

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Q1 MEDICINE, RESEARCH & EXPERIMENTAL

影响因子： 11.8 最新[2024版] 11.8 最新五年平均 0 出版当年[2019版] 0 出版当年五年平均 0 出版前一年[2018版]

第一作者：

第一作者机构： [1]Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China. [5]Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China.

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通讯作者：

通讯机构： [1]Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China. [2]Department of Gastroenterology, Wuhan Third Hospital & Tongren Hospital of Wuhan University, Wuhan, China. [3]Institute of Model Animal, Wuhan University, Wuhan, China. [7]The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China. [16]Department of Anesthesiology, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.

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