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SARS-CoV-2 proteins

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    Development of a predictive risk model for severe COVID-19 MESHD disease using population-based administrative data

    Authors: Jiandong Zhou; Sharen Lee; Xiansong Wang; Yi Li; William KK Wu; Tong Liu; Zhidong Cao; Daniel Dajun Zeng; Ian CK Wong; Bernard MY Cheung; Qingpeng Zhang; Gary Tse

    doi:10.1101/2020.10.21.20217380 Date: 2020-10-25 Source: medRxiv

    Background: Recent studies have reported numerous significant predictors for adverse outcomes in COVID-19 MESHD disease. However, there have been few simple clinical risk score for prompt risk stratification. The objective is to develop a simple risk score for severe COVID-19 MESHD disease using territory-wide healthcare data based on simple clinical and laboratory variables. Methods: Consecutive patients admitted to Hong Kong public hospitals between 1st January and 22nd August 2020 diagnosed with COVID-19 MESHD, as confirmed by RT-PCR, were included. The primary outcome was composite intensive care unit admission, need for intubation or death with follow-up until 8th September 2020. Results: COVID-19 MESHD testing was performed in 237493 patients and 4445 patients (median age 44.8 years old, 95% CI: [28.9, 60.8]); 50% male) were tested positive. Of these, 212 patients (4.8%) met the primary outcome. A risk score including the following components was derived from Cox regression: gender, age, hypertension MESHD, stroke MESHD, diabetes mellitus MESHD, ischemic MESHD heart disease MESHD/ heart failure MESHD, respiratory disease MESHD, renal disease MESHD, increases in neutrophil count, monocyte count, sodium, potassium, urea, alanine transaminase, alkaline phosphatase, high sensitive troponin-I, prothrombin HGNC time, activated partial thromboplastin time, D-dimer and C-reactive protein HGNC, as well as decreases in lymphocyte count, base excess and bicarbonate levels. The model based on test results taken on the day of admission demonstrated an excellent predictive value. Incorporation of test results on successive time points did not further improve risk prediction. Conclusions: A simple clinical score accurately predicted severe COVID-19 MESHD disease, even without including symptoms, blood pressure or oxygen status on presentation, or chest radiograph results.

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MeSH Disease
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SARS-CoV-2 Proteins


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