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Yuan Y, Sun C, Tang X, Cheng C, Mombaerts L, Wang M, Hu T, Sun C, Guo Y, Li X, Xu H, Ren T, Xiao Y, Xiao Y, Zhu H, Wu H, Li K, Chen C, Liu Y, Liang Z, Cao Z, Zhang HT, Paschaldis IC, Liu Q, Goncalves J, Zhong Q, Yan L. Development and Validation of a Prognostic Risk Score System for COVID-19 Inpatients: A Multi-Center Retrospective Study in China. ENGINEERING (BEIJING, CHINA) 2022; 8:116-121. [PMID: 33282444 PMCID: PMC7695569 DOI: 10.1016/j.eng.2020.10.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/04/2020] [Accepted: 10/11/2020] [Indexed: 05/14/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic. Hospitalized patients of COVID-19 suffer from a high mortality rate, motivating the development of convenient and practical methods that allow clinicians to promptly identify high-risk patients. Here, we have developed a risk score using clinical data from 1479 inpatients admitted to Tongji Hospital, Wuhan, China (development cohort) and externally validated with data from two other centers: 141 inpatients from Jinyintan Hospital, Wuhan, China (validation cohort 1) and 432 inpatients from The Third People's Hospital of Shenzhen, Shenzhen, China (validation cohort 2). The risk score is based on three biomarkers that are readily available in routine blood samples and can easily be translated into a probability of death. The risk score can predict the mortality of individual patients more than 12 d in advance with more than 90% accuracy across all cohorts. Moreover, the Kaplan-Meier score shows that patients can be clearly differentiated upon admission as low, intermediate, or high risk, with an area under the curve (AUC) score of 0.9551. In summary, a simple risk score has been validated to predict death in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); it has also been validated in independent cohorts.
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Affiliation(s)
- Ye Yuan
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Chuan Sun
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Xiuchuan Tang
- School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Cheng Cheng
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Laurent Mombaerts
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belval L-4367, Luxembourg
| | - Maolin Wang
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Tao Hu
- Department of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, Chicago, IL 60657, USA
| | - Yuqi Guo
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Xiuting Li
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Hui Xu
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Tongxin Ren
- Huazhong University of Science and Technology-Wuxi Research Institute, Wuxi 214174, China
| | - Yang Xiao
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Yaru Xiao
- Department of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Hongling Zhu
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Honghan Wu
- Institute of Health Informatics, University College London, London NW1 2DA, UK
| | - Kezhi Li
- Institute of Health Informatics, University College London, London NW1 2DA, UK
| | - Chuming Chen
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen 518055, China
| | - Yingxia Liu
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen 518055, China
| | - Zhichao Liang
- Department of Infectious Diseases, Shenzhen Key Laboratory of Pathogenic Microbiology and Immunology, National Clinical Research Center for Infectious Disease, The Third People's Hospital of Shenzhen (Second Hospital Affiliated with the Southern University of Science and Technology), Shenzhen 518055, China
| | - Zhiguo Cao
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Hai-Tao Zhang
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Ioannis Ch Paschaldis
- Department of Electrical and Computer Engineering & Division of Systems Engineering & Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
| | - Quanying Liu
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jorge Goncalves
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belval L-4367, Luxembourg
- Department of Plant Sciences, University of Cambridge, Cambridge CB2 1TN, UK
| | - Qiang Zhong
- Department of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Li Yan
- Department of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Yu J, Wang G, Davidson A, Chow I, Chiu A. Antibiotics Utilization for Community Acquired Pneumonia in a Community Hospital Emergency Department. J Pharm Pract 2020; 35:62-69. [PMID: 32912068 DOI: 10.1177/0897190020953032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND A local health authority in Canada implemented its own Antimicrobial Stewardship Program (ASP) which provide guidelines to clinicians to utilize when treating infectious diseases such as community-acquired pneumonia (CAP). Objectives: The primary objective is to describe antibiotic usage patterns at the community hospital's emergency department (ED) and to analyze the patterns in relation to ASP goals of reducing risk of infections, adverse drug events and antibiotic resistance, and to identify potential areas of improvement. METHODS This retrospective chart review included 156 adult patients with a diagnosis of CAP admitted to a community hospital ED from December 1, 2015 to November 30, 2016. RESULTS 50.6% patients were prescribed moxifloxacin across all severity of CAP patients. Low and moderate severity CAP patients were most often prescribed antibiotic duration > 7 days. In low, moderate and high severity CAP patients who were treated using ceftriaxone, 100%, 88.9% and 66.6% patients were treated with ceftriaxone 2000 mg daily respectively. CONCLUSIONS Antibiotic prescribing patterns suggest fluoroquinolones were frequently being over-prescribed, ceftriaxone dosages were often too high, and duration of antibiotics for low and moderate severity CAP were too long. More efforts are needed to promote appropriate antibiotic usage and optimize patient care.
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Affiliation(s)
| | - Gillian Wang
- Peace Arch Hospital (PAH), White Rock, British Columbia, Canada
| | - Ann Davidson
- Peace Arch & Delta Hospitals, White Rock, British Columbia, Canada
| | - Ivy Chow
- Peace Arch Hospital, Antimicrobial Stewardship, White Rock, British Columbia, Canada
| | - Ada Chiu
- Peace Arch Hospital, Emergency Department, White Rock, British Columbia, Canada
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