Objectives: Early identification of patients with the novel coronavirus induced-disease 2019 (COVID-19) and pneumonia is
currently challenging. Few data are available on validated scores
predictive of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)
infection. The Portuguese Society of Intensive Care (PSIC) proposed a risk
score whose main goals were to predict a higher probability of COVID-19 and
optimize hospital resources, adjusting patients’ intervention. This study aimed
to validate the PSIC risk score applied to inpatients with pneumonia. Methods: A retrospective analysis of 207 patients with pneumonia admitted to a
suspected/confirmed SARS-CoV-2 infection
specialized ward (20/03 to 20/05/2020) was performed. Score variables
were analyzed to determine the significance of the independent predictive variables on the probability of a
positive SARS-CoV-2 rRT-PCR test. The binary logistic regression
modeling approach was selected. The best cut-off value was obtained with the
Receiver Operating Characteristic (ROC) curve together with the evaluation of
the discriminatory power through the Area Under the Curve (AUC). Results: The
validation cohort included145 patients. Typical chest
computed-tomography features (OR, 12.16; 95%CI, 3.32-44.50)
and contact with a positive SARS-CoV-2 patient (OR, 6.56;
References
[1]
WHO (2020) World Health Organization. Pneumonia of Unknown Cause—China. https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/
[2]
Wynants, L., Calster, V.B., Collins, B., Riley, R.D., Heinze, G., Schuit, E., et al. (2020) Prediction Models for Diagnosis and Prognosis of COVID-19: Systematic Review and Critical Appraisal. BMJ, 369, m1328. https://doi.org/10.1136/bmj.m1328
[3]
Wu, D., Wu, T., Liu, Q. and Yang, Z. (2020) The SARS-CoV-2 Outbreak: What We Know. International Journal of Infectious Diseases, 94, 44-48. https://doi.org/10.1016/j.ijid.2020.03.004
[4]
Woloshin, S., Patel, N. and Kesselheim, A.S. (2020) False Negative Tests for SARS-CoV-2 Infection—Challenges and Implications. The New England Journal of Medicine, 383, e38. https://doi.org/10.1056/NEJMp2015897
[5]
SPCI (2020) Recomendaèões da Sociedade Portuguesa de Cuidados Intensivos para a Abordagem do COVID-19 em Medicina Intensiva—Diagnóstico de Infeção. https://www.spci.pt/media/covid-19/COVID_19_R_20200322.pdf
[6]
Ai, T., Yang, Z., Hou, H., Zhan, C., Chen, C., Lv, W., et al. (2020) Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology, 296, E32–E40. https://doi.org/10.1148/radiol.2020200642
[7]
Feng, C., Huang, Z., Wang, L., Chen, X., Zhai, Y., Zhu F., et al. (2020) A Novel Triage Tool of Artificial Intelligence Assisted Diagnosis Aid System for Suspected COVID-19 Pneumonia in Fever Clinics. MedRxiv.
[8]
Wang, Z., Weng, J., Li, Z., Hou, R., Zhou, L., Ye, H., et al. (2020) Development and Validation of a Diagnostic Nomogram to Predict COVID-19 Pneumonia. MedRxiv.
[9]
Richardson, S., Hirsch, J.S., Narasimhan, M., Crawford, J.M., McGinn, T., Davidson, K.W., et al. (2020) Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA, 323, 2052-2059. https://doi.org/10.1001/jama.2020.6775
[10]
Mohammadi, A., Esmaeilzadeh, E., Li, Y., Bosch, R.J. and Li, J.Z. (2020) SARS-CoV-2 Detection in Different Respiratory Sites: A Systematic Review and Meta-analysis. EBioMedicine, 59, Article No. 102903. https://doi.org/10.1016/j.ebiom.2020.102903
[11]
Petrilli, C.M., Jones, S.A., Yang, J., Rajagopalan, H., O’Donnell, L., Chemyak, Y., et al. (2020) Factors Associated with Hospital Admission and Critical Illness Among 5279 People with Coronavirus Disease 2019 in New York City: Prospective Cohort Study. BMJ, 369, m1966. https://doi.org/10.1136/bmj.m1966
[12]
Doherty, A., Harrison, E.M., Green, C.A., Hardwick, H.E., Pius, R., Norman, L., et al. (2020) Features of 20133 UK Patients in Hospital with COVID-19 Using the ISARIC WHO Clinical Characterization Protocol: Prospective Observational Cohort Study. BMJ, 369, m1985. https://doi.org/10.1136/bmj.m1985
[13]
Burgos, J., Luján, M., Larrosa, N., Fontanals, D., Bermudo, G., Planes, A.M., et al. (2014) Risk Factors for Respiratory Failure in Pneumococcal Pneumonia: The Importance of Pneumococcal Serotypes. European Respiratory Journal, 43, 545-553. https://doi.org/10.1183/09031936.00050413
[14]
Torres, A., Peetermans, W.E., Viegi, G. and Blasi, F. (2013) Risk Factors for Community-Acquired Pneumonia in Adults in Europe: A Literature Review. Thorax, 68, 1057-1065. https://doi.org/10.1136/thoraxjnl-2013-204282
[15]
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., et al. (2020) Clinical Features of Patients Infected with the 2019 Novel Coronavirus in Wuhan, China. The Lancet, 395, 497-506. https://doi.org/10.1016/S0140-6736(20)30183-5
[16]
Chen, N., Zhau, M., Dong, X., Qu, J., Gong, F., Han, Y., et al. (2020) Epidemiological and Clinical Characteristics of 99 Cases of 2019 Novel coronavirus Pneumonia in Wuhan, China: a Descriptive Study. The Lancet, 395, 507-513. https://doi.org/10.1016/S0140-6736(20)30211-7
[17]
Zhao, Q., Meng, M., Kumar, R., Wu, Y., Huang, J., Deng, Y., et al. (2020) Lymphopenia is Associated with Severe Coronavirus Disease 2019 (COVID-19) Infections: A Systemic Review and Meta-Analysis. International Journal of Infectious Diseases, 96, 131-135. https://doi.org/10.1016/j.ijid.2020.04.086