Yann Nguyen1,2, Félix Corre1, Vasco Honsel1, Sonja Curac3, Virginie Zarrouk1, Catherine Paugam Burtz4, Emmanuel Weiss4, Jean-Denis Moyer4, Tobias Gauss4, Jules Grégory5, Frédéric Bert6, Catherine Trichet7, Katell Peoc'h8, Valérie Vilgrain5, Vinciane Rebours9, Bruno Fantin1, Adrien Galy1. 1. Departement of Internal Medicine, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France. 2. Centre for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France. 3. Emergency Department, AP-HP.Nord, Beaujon Hospital, Clichy, France. 4. Department of Anaesthesiology and Intensive Care, AP-HP.Nord, Beaujon Hospital, DMU PARABOL, University of Paris, Clichy, France. 5. Department of Radiology, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France. 6. Laboratory of Microbiology, AP-HP.Nord, Beaujon Hospital, Clichy, France. 7. Laboratory of Hematology and Hemostasis, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France. 8. Laboratory of Biochemistry, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France. 9. Departement of Pancreatology, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France.
Abstract
OBJECTIVE: To identify predictive factors of unfavourable outcome among patients hospitalized for COVID-19. METHODS: We conducted a monocentric retrospective cohort study of COVID-19 patients hospitalized in Paris area. An unfavourable outcome was defined as the need for artificial ventilation and/or death. Characteristics at admission were analysed to identify factors predictive of unfavourable outcome using multivariable Cox proportional hazard models. Based on the results, a nomogram to predict 14-day probability of poor outcome was proposed. RESULTS: Between March 15th and April 14th, 2020, 279 COVID-19 patients were hospitalized after a median of 7 days after the first symptoms. Among them, 88 (31.5%) patients had an unfavourable outcome: 48 were admitted to the ICU for artificial ventilation, and 40 patients died without being admitted to ICU. Multivariable analyses retained age, overweight, polypnoea, fever, high C-reactive protein, elevated us troponin-I, and lymphopenia as risk factors of an unfavourable outcome. A nomogram was established with sufficient discriminatory power (C-index 0.75), and proper consistence between the prediction and the observation. CONCLUSION: We identified seven easily available prognostic factors and proposed a simple nomogram for early detection of patients at risk of aggravation, in order to optimize clinical care and initiate specific therapies. KEY MESSAGES Since novel coronavirus disease 2019 pandemic, a minority of patients develops severe respiratory distress syndrome, leading to death despite intensive care. Tools to identify patients at risk in European populations are lacking. In our series, age, respiratory rate, overweight, temperature, C-reactive protein, troponin and lymphocyte counts were risk factors of an unfavourable outcome in hospitalized adult patients. We propose an easy-to-use nomogram to predict unfavourable outcome for hospitalized adult patients to optimize clinical care and initiate specific therapies.
OBJECTIVE: To identify predictive factors of unfavourable outcome among patients hospitalized for COVID-19. METHODS: We conducted a monocentric retrospective cohort study of COVID-19patients hospitalized in Paris area. An unfavourable outcome was defined as the need for artificial ventilation and/or death. Characteristics at admission were analysed to identify factors predictive of unfavourable outcome using multivariable Cox proportional hazard models. Based on the results, a nomogram to predict 14-day probability of poor outcome was proposed. RESULTS: Between March 15th and April 14th, 2020, 279 COVID-19patients were hospitalized after a median of 7 days after the first symptoms. Among them, 88 (31.5%) patients had an unfavourable outcome: 48 were admitted to the ICU for artificial ventilation, and 40 patientsdied without being admitted to ICU. Multivariable analyses retained age, overweight, polypnoea, fever, high C-reactive protein, elevated us troponin-I, and lymphopenia as risk factors of an unfavourable outcome. A nomogram was established with sufficient discriminatory power (C-index 0.75), and proper consistence between the prediction and the observation. CONCLUSION: We identified seven easily available prognostic factors and proposed a simple nomogram for early detection of patients at risk of aggravation, in order to optimize clinical care and initiate specific therapies. KEY MESSAGES Since novel coronavirus disease 2019 pandemic, a minority of patients develops severe respiratory distress syndrome, leading to death despite intensive care. Tools to identify patients at risk in European populations are lacking. In our series, age, respiratory rate, overweight, temperature, C-reactive protein, troponin and lymphocyte counts were risk factors of an unfavourable outcome in hospitalized adult patients. We propose an easy-to-use nomogram to predict unfavourable outcome for hospitalized adult patients to optimize clinical care and initiate specific therapies.
Authors: Mohammad Rubayet Hasan; Khaled Al Zubaidi; Karim Diab; Yahia Hejazi; Sharon Bout-Tabaku; Buthaina Al-Adba; Eman Al Maslamani; Mohammad Janahi; Diane Roscoe; Andres Perez Lopez; Patrick Tang Journal: BMC Pediatr Date: 2021-06-08 Impact factor: 2.125
Authors: Mubbasheer Ahmed; Shailesh Advani; Axel Moreira; Sarah Zoretic; John Martinez; Kevin Chorath; Sebastian Acosta; Rija Naqvi; Finn Burmeister-Morton; Fiona Burmeister; Aina Tarriela; Matthew Petershack; Mary Evans; Ansel Hoang; Karthik Rajasekaran; Sunil Ahuja; Alvaro Moreira Journal: EClinicalMedicine Date: 2020-09-04