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A Novel Approach for COVID-19 Patient Condition Tracking: From Instant Prediction to Regular Monitoring.
Bakin, Evgeny A; Stanevich, Oksana V; Chmelevsky, Mikhail P; Belash, Vasily A; Belash, Anastasia A; Savateeva, Galina A; Bokinova, Veronika A; Arsentieva, Natalia A; Sayenko, Ludmila F; Korobenkov, Evgeny A; Lioznov, Dmitry A; Totolian, Areg A; Polushin, Yury S; Kulikov, Alexander N.
Afiliación
  • Bakin EA; Raisa Gorbacheva Memorial Research Institute for Pediatric Oncology, Hematology and Transplantation, First Pavlov State Medical University, St. Petersburg, Russia.
  • Stanevich OV; Research Department, Bioinformatics Institute, St. Petersburg, Russia.
  • Chmelevsky MP; Department of Infectious Diseases and Epidemiology, First Pavlov State Medical University, St. Petersburg, Russia.
  • Belash VA; Research Department, Smorodintsev Research Institute of Influenza, St. Petersburg, Russia.
  • Belash AA; Department of Functional Diagnostics, First Pavlov State Medical University, St. Petersburg, Russia.
  • Savateeva GA; World-Class Scientific Center, Saint Petersburg Electrotechnical University "LETI", St. Petersburg, Russia.
  • Bokinova VA; Center for COVID-19 Treatment, First Pavlov State Medical University, St. Petersburg, Russia.
  • Arsentieva NA; Center for COVID-19 Treatment, First Pavlov State Medical University, St. Petersburg, Russia.
  • Sayenko LF; Center for COVID-19 Treatment, First Pavlov State Medical University, St. Petersburg, Russia.
  • Korobenkov EA; Center for COVID-19 Treatment, First Pavlov State Medical University, St. Petersburg, Russia.
  • Lioznov DA; Department of Molecular Immunology, Saint Petersburg Pasteur Institute, St. Petersburg, Russia.
  • Totolian AA; Information Technology Department, First Pavlov State Medical University, St. Petersburg, Russia.
  • Polushin YS; Information Technology Department, First Pavlov State Medical University, St. Petersburg, Russia.
  • Kulikov AN; Department of Infectious Diseases and Epidemiology, First Pavlov State Medical University, St. Petersburg, Russia.
Front Med (Lausanne) ; 8: 744652, 2021.
Article en En | MEDLINE | ID: mdl-34950678
Purpose: The aim of this research is to develop an accurate and interpretable aggregated score not only for hospitalization outcome prediction (death/discharge) but also for the daily assessment of the COVID-19 patient's condition. Patients and Methods: In this single-center cohort study, real-world data collected within the first two waves of the COVID-19 pandemic was used (27.04.2020-03.08.2020 and 01.11.2020-19.01.2021, respectively). The first wave data (1,349 cases) was used as a training set for the score development, while the second wave data (1,453 cases) was used as a validation set. No overlapping cases were presented in the study. For all the available patients' features, we tested their association with an outcome. Significant features were taken for further analysis, and their partial sensitivity, specificity, and promptness were estimated. Sensitivity and specificity were further combined into a feature informativeness index. The developed score was derived as a weighted sum of nine features that showed the best trade-off between informativeness and promptness. Results: Based on the training cohort (median age ± median absolute deviation 58 ± 13.3, females 55.7%), the following resulting score was derived: APTT (4 points), CRP (3 points), D-dimer (4 points), glucose (4 points), hemoglobin (3 points), lymphocytes (3 points), total protein (6 points), urea (5 points), and WBC (4 points). Internal and temporal validation based on the second wave cohort (age 60 ± 14.8, females 51.8%) showed that a sensitivity and a specificity over 90% may be achieved with an expected prediction range of more than 7 days. Moreover, we demonstrated high robustness of the score to the varying peculiarities of the pandemic. Conclusions: An extensive application of the score during the pandemic showed its potential for optimization of patient management as well as improvement of medical staff attentiveness in a high workload stress. The transparent structure of the score, as well as tractable cutoff bounds, simplified its implementation into clinical practice. High cumulative informativeness of the nine score components suggests that these are the indicators that need to be monitored regularly during the follow-up of a patient with COVID-19.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Front Med (Lausanne) Año: 2021 Tipo del documento: Article País de afiliación: Rusia Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Front Med (Lausanne) Año: 2021 Tipo del documento: Article País de afiliación: Rusia Pais de publicación: Suiza