Development of a multivariate prediction model of intensive care unit transfer or death: A French prospective cohort study of hospitalized COVID-19 patients

Yves Allenbach, David Saadoun, Georgina Maalouf, Matheus Vieira, Alexandra Hellio, Jacques Boddaert, Hélène Gros, Joe Elie Salem, Matthieu Resche Rigon, Cherifa Menyssa, Lucie Biard, Olivier Benveniste, Patrice Cacoub, Ahlem Chaib, Nicolas Champtiaux, Aude Rigolet, Anne Simon, Stéphane Barete, Jean Charles Piette Perrine Guillaume-Jugnot, Yasmina FerfarMathieu Vautier, Ségolène Toquet-Bouedec, Christian de Gennes, Fanny Domont, Gaëlle Leroux, Mathilde Leclercq, Chloé Comarmond, Anne Claire Desbois, Nabiha Sbeih, Amine Ghembaza, Joana Alves-Vieira, Hugues Gontier, Sofia Garabetyan, Marion Larue, Andréa Patissier, Elissone Sarkis, Sandrine Tramond, Roxana Maria Bogdan, Nicias Gorge, Benjamin Rossi, Marie Anne Bouldouyre, Hélène Guillot, Keito Le Goff, Leila Lefevre, Serge Barmo, Ana Maria Cardamisa, Margot Hulin, Alexandre Lejoncour, Céline Anquetil, Bailly Laurent, Corti Léonard, Gonçalo Boleto, Cindye Marques, Félix Blanc, Charlotte Bouzbib, Sara Philonenkon, Violaine Foltz, Jeremy Rezai, Christiane Stern, Manon Allaire, Philippe Sultanik, Oussama Mouri, Alessandra Mazzola, Frédérique Gandjbakhch, Eouard Larrey, Laure Gossec, Charlotte Tomeo, Vincent Mallet, Clémence Fron, Marika Rudler, Aline Lecleach, Bruno Fautrel, Pascal Lebray

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    Résumé

    Prognostic factors of coronavirus disease 2019 (COVID-19) patients among European population are lacking. Our objective was to identify early prognostic factors upon admission to optimize the management of COVID-19 patients hospitalized in a medical ward. This French single-center prospective cohort study evaluated 152 patients with positive severe acute respiratory syndrome coronavirus 2 real-time reverse transcriptase–polymerase chain reaction assay, hospitalized in the Internal Medicine and Clinical Immunology Department, at Pitié-Salpêtrière’s Hospital, in Paris, France, a tertiary care university hospital. Predictive factors of intensive care unit (ICU) transfer or death at day 14 (D14), of being discharge alive and severe status at D14 (remaining with ventilation, or death) were evaluated in multivariable logistic regression models; models’ performances, including discrimination and calibration, were assessed (C-index, calibration curve, R2, Brier score). A validation was performed on an external sample of 132 patients hospitalized in a French hospital close to Paris, in Aulnay-sous-Bois, Île-de-France. The probability of ICU transfer or death was 32% (47/147) (95% CI 25–40). Older age (OR 2.61, 95% CI 0.96–7.10), poorer respiratory presentation (OR 4.04 per 1-point increment on World Health Organization (WHO) clinical scale, 95% CI 1.76–9.25), higher CRP-level (OR 1.63 per 100mg/L increment, 95% CI 0.98–2.71) and lower lymphocytes count (OR 0.36 per 1000/mm3 increment, 95% CI 0.13–0.99) were associated with an increased risk of ICU requirement or death. A 9-point ordinal scale scoring system defined low (score 0–2), moderate (score 3–5), and high (score 6–8) risk patients, with predicted respectively 2%, 25% and 81% risk of ICU transfer or death at D14. Therefore, in this prospective cohort study of laboratory-confirmed COVID-19 patients hospitalized in a medical ward in France, a simplified scoring system at admission predicted the outcome at D14.

    langue originaleAnglais
    Numéro d'articlee0240711
    journalPLoS ONE
    Volume15
    Numéro de publication10 October
    Les DOIs
    étatPublié - 1 oct. 2020

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