• Vishnu Shankar, Pearlsy Grace Rajan, Yuvaraj Krishnamoorthy, Damal Kandadai Sriram, Melvin George, S Melina I Sahay, and B Jagan Nathan.
• Department of General Medicine, Hindu Mission Hospital, Chengalpattu, India.
• Ir J Med Sci. 2022 Dec 1; 191 (6): 282328312823-2831.

BackgroundDevelopment of a prediction model using baseline characteristics of COVID-19 patients at the time of diagnosis will aid us in early identification of the high-risk groups and devise pertinent strategies accordingly. Hence, we did this study to develop a prognostic-scoring system for predicting the COVID-19 severity in South India.MethodsWe undertook this retrospective cohort study among COVID-19 patients reporting to Hindu Mission Hospital, India. Multivariable logistic regression using the LASSO procedure was used to select variables for the model building, and the nomogram scoring system was developed with the final selected model. Model discrimination, calibration, and decision curve analysis (DCA) was performed.ResultsIn total, 35.1% of the patients in the training set developed severe COVID-19 during their follow-up period. In the basic model, nine variables (age group, sex, education, chronic kidney disease, tobacco, cough, dyspnea, olfactory-gustatory dysfunction [OGD], and gastrointestinal symptoms) were selected and a nomogram was built using these variables. In the advanced model, in addition to these variables (except OGD), C-reactive protein, lactate dehydrogenase, ferritin, D-dimer, and CT severity score were selected. The discriminatory power (c-index) for basic model was 0.78 (95%CI: 0.74-0.82) and advanced model was 0.83 (95%CI: 0.79-0.87). DCA showed that both the models are beneficial at a threshold probability around 10-95% than treat-none or treat-all strategies.ConclusionThe present study has developed two separate prognostic-scoring systems to predict the COVID-19 severity. This scoring system could help the clinicians and policymakers to devise targeted interventions and in turn reduce the COVID-19 mortality in India.© 2021. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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