Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19

14 mai 2020

Source : JAMA Internal Medicine

Auteurs :Wenhua Liang and al.


“Un article sur la mise au point d’un score de prédiction du risque de formes sévères de COVID-19 (disponible sur internet). Il est intéressant de constater que les auteurs n’ont pas proposé de classement de type bas/moyen/haut risque, considérant que ce niveau de gravité doit être laissé à l’appréciation du médecin, en fonction de l’état clinique du patient bien entendu, mais aussi des ressources matérielles disponibles et de la situation épidémiologique locale.  ” présenté par le Dr Marie MOITRY

Key Points

Question

What epidemiological and clinical characteristics are associated with the development of critical illness among patients with novel corona virus disease-2019 (COVID-19)? Can these characteristics be used to predict which patients admitted to the hospital with COVID-19 will need admission to an intensive care unit, mechanical ventilation, or will die?

Findings

In this study with a development cohort of 1590 patients and a validation cohort of 710 patients, a risk score was developed and validated to predict development of critical illness. We identified 10 independent predictors and developed a risk score (COVID-GRAM) that predicts development of critical illness. The risk score predictors included: chest radiography abnormality, age, hemoptysis, dyspnea, unconsciousness, number of comorbidities, cancer history, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, and direct bilirubin.

Meaning

The COVID risk score may help identify patients with COVID-19 who may subsequently develop critical illness.


Télécharger l’article complet

© Les Hôpitaux Universitaires de Strasbourg 2020 - Tous droits réservés