• Ze Chen, Jing Chen, Jianghua Zhou, Fang Lei, Feng Zhou, Juan-Juan Qin, Xiao-Jing Zhang, Lihua Zhu, Ye-Mao Liu, Haitao Wang, Ming-Ming Chen, Yan-Ci Zhao, Jing Xie, Lijun Shen, Xiaohui Song, Xingyuan Zhang, Chengzhang Yang, Weifang Liu, Xiao Zhang, Deliang Guo, Youqin Yan, Mingyu Liu, Weiming Mao, Liming Liu, Ping Ye, Bing Xiao, Pengcheng Luo, Zixiong Zhang, Zhigang Lu, Junhai Wang, Haofeng Lu, Xigang Xia, Daihong Wang, Xiaofeng Liao, Gang Peng, Liang Liang, Jun Yang, Guohua Chen, Elena Azzolini, Alessio Aghemo, Michele Ciccarelli, Gianluigi Condorelli, Giulio G Stefanini, Xiang Wei, Bing-Hong Zhang, Xiaodong Huang, Jiahong Xia, Yufeng Yuan, Zhi-Gang She, Jiao Guo, Yibin Wang, Peng Zhang, and Hongliang Li.
• Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China.
• Curr Med Res Opin. 2021 Jun 1; 37 (6): 917-927.

BackgroundTo develop a sensitive and clinically applicable risk assessment tool identifying coronavirus disease 2019 (COVID-19) patients with a high risk of mortality at hospital admission. This model would assist frontline clinicians in optimizing medical treatment with limited resources.Methods6415 patients from seven hospitals in Wuhan city were assigned to the training and testing cohorts. A total of 6351 patients from another three hospitals in Wuhan, 2169 patients from outside of Wuhan, and 553 patients from Milan, Italy were assigned to three independent validation cohorts. A total of 64 candidate clinical variables at hospital admission were analyzed by random forest and least absolute shrinkage and selection operator (LASSO) analyses.ResultsEight factors, namely, Oxygen saturation, blood Urea nitrogen, Respiratory rate, admission before the date the national Maximum number of daily new cases was reached, Age, Procalcitonin, C-reactive protein (CRP), and absolute Neutrophil counts, were identified as having significant associations with mortality in COVID-19 patients. A composite score based on these eight risk factors, termed the OURMAPCN-score, predicted the risk of mortality among the COVID-19 patients, with a C-statistic of 0.92 (95% confidence interval [CI] 0.90-0.93). The hazard ratio for all-cause mortality between patients with OURMAPCN-score >11 compared with those with scores ≤ 11 was 18.18 (95% CI 13.93-23.71; p < .0001). The predictive performance, specificity, and sensitivity of the score were validated in three independent cohorts.ConclusionsThe OURMAPCN score is a risk assessment tool to determine the mortality rate in COVID-19 patients based on a limited number of baseline parameters. This tool can assist physicians in optimizing the clinical management of COVID-19 patients with limited hospital resources.

15 keywords...

hide…