دورية أكاديمية
Facilitating Safe Discharge Through Predicting Disease Progression in Moderate Coronavirus Disease 2019 (COVID-19): A Prospective Cohort Study to Develop and Validate a Clinical Prediction Model in Resource-Limited Settings.
| العنوان: | Facilitating Safe Discharge Through Predicting Disease Progression in Moderate Coronavirus Disease 2019 (COVID-19): A Prospective Cohort Study to Develop and Validate a Clinical Prediction Model in Resource-Limited Settings. |
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| المؤلفون: | Chandna A; Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia.; Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom., Mahajan R; Médecins Sans Frontières, New Delhi, India., Gautam P; Department of Infectious Diseases, Christian Medical College, Vellore, India., Mwandigha L; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom., Gunasekaran K; Department of Medicine, Christian Medical College, Vellore, India., Bhusan D; Department of Internal Medicine, All India Institute of Medical Sciences, Patna, India., Cheung ATL; Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom.; Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand., Day N; Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom.; Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand., Dittrich S; Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom.; Foundation for Innovative Diagnostics, Geneva, Switzerland., Dondorp A; Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom.; Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand., Geevar T; Department of Transfusion Medicine & Immunohaematology, Christian Medical College, Vellore, India., Ghattamaneni SR; Médecins Sans Frontières, New Delhi, India., Hussain S; Médecins Sans Frontières, New Delhi, India., Jimenez C; Médecins Sans Frontières, New Delhi, India., Karthikeyan R; Department of Infectious Diseases, Christian Medical College, Vellore, India., Kumar S; Department of Cardiothoracic & Vascular Surgery, All India Institute of Medical Sciences, Patna, India., Kumar S; Department of Virology, Rajendra Memorial Research Institute of Medical Sciences, Patna, India., Kumar V; Médecins Sans Frontières, New Delhi, India., Kundu D; Department of Infectious Diseases, Christian Medical College, Vellore, India., Lakshmanan A; Médecins Sans Frontières, New Delhi, India., Manesh A; Department of Infectious Diseases, Christian Medical College, Vellore, India., Menggred C; Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand., Moorthy M; Department of Clinical Virology, Christian Medical College, Vellore, India., Osborn J; Foundation for Innovative Diagnostics, Geneva, Switzerland., Richard-Greenblatt M; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Sharma S; Department of Biochemistry, All India Institute of Medical Sciences, Patna, India., Singh VK; Department of Burns & Plastic Surgery, All India Institute of Medical Sciences, Patna, India., Singh VK; Médecins Sans Frontières, New Delhi, India., Suri J; Médecins Sans Frontières, New Delhi, India., Suzuki S; School of Tropical Medicine & Global Health, Nagasaki University, Nagasaki, Japan., Tubprasert J; Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand., Turner P; Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia.; Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom., Villanueva AMG; School of Tropical Medicine & Global Health, Nagasaki University, Nagasaki, Japan., Waithira N; Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom.; Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand., Kumar P; Department of Community & Family Medicine, All India Institute of Medical Sciences, Patna, Indiaand., Varghese GM; Department of Infectious Diseases, Christian Medical College, Vellore, India., Koshiaris C; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom., Lubell Y; Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom.; Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand., Burza S; Médecins Sans Frontières, New Delhi, India.; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom. |
| المصدر: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2022 Aug 24; Vol. 75 (1), pp. e368-e379. |
| نوع المنشور: | Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 9203213 Publication Model: Print Cited Medium: Internet ISSN: 1537-6591 (Electronic) Linking ISSN: 10584838 NLM ISO Abbreviation: Clin Infect Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Jan. 2011- : Oxford : Oxford University Press Original Publication: Chicago, IL : The University of Chicago Press, c1992- |
| مواضيع طبية MeSH: | COVID-19*/diagnosis, Adult ; Disease Progression ; Humans ; Interleukin-6 ; Models, Statistical ; Patient Discharge ; Patient Safety ; Prognosis ; Prospective Studies ; Receptors, Urokinase Plasminogen Activator ; Reproducibility of Results ; SARS-CoV-2 |
| مستخلص: | Background: In locations where few people have received coronavirus disease 2019 (COVID-19) vaccines, health systems remain vulnerable to surges in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. Tools to identify patients suitable for community-based management are urgently needed. Methods: We prospectively recruited adults presenting to 2 hospitals in India with moderate symptoms of laboratory-confirmed COVID-19 to develop and validate a clinical prediction model to rule out progression to supplemental oxygen requirement. The primary outcome was defined as any of the following: SpO2 < 94%; respiratory rate > 30 BPM; SpO2/FiO2 < 400; or death. We specified a priori that each model would contain three clinical parameters (age, sex, and SpO2) and 1 of 7 shortlisted biochemical biomarkers measurable using commercially available rapid tests (C-reactive protein [CRP], D-dimer, interleukin 6 [IL-6], neutrophil-to-lymphocyte ratio [NLR], procalcitonin [PCT], soluble triggering receptor expressed on myeloid cell-1 [sTREM-1], or soluble urokinase plasminogen activator receptor [suPAR]), to ensure the models would be suitable for resource-limited settings. We evaluated discrimination, calibration, and clinical utility of the models in a held-out temporal external validation cohort. Results: In total, 426 participants were recruited, of whom 89 (21.0%) met the primary outcome; 257 participants comprised the development cohort, and 166 comprised the validation cohort. The 3 models containing NLR, suPAR, or IL-6 demonstrated promising discrimination (c-statistics: 0.72-0.74) and calibration (calibration slopes: 1.01-1.05) in the validation cohort and provided greater utility than a model containing the clinical parameters alone. Conclusions: We present 3 clinical prediction models that could help clinicians identify patients with moderate COVID-19 suitable for community-based management. The models are readily implementable and of particular relevance for locations with limited resources. (© The Author(s) 2022. Published by Oxford University Press for the Infectious Diseases Society of America.) |
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| معلومات مُعتمدة: | United Kingdom WT_ Wellcome Trust; 211182/Z/18/Z United Kingdom WT_ Wellcome Trust; 220211 United Kingdom WT_ Wellcome Trust; 15604/Z/19/Z United Kingdom WT_ Wellcome Trust |
| فهرسة مساهمة: | Keywords: COVID-19; LMIC; low- and middle-income country; prognostic model; triage |
| سلسلة جزيئية: | ClinicalTrials.gov NCT04441372 |
| المشرفين على المادة: | 0 (Interleukin-6) 0 (Receptors, Urokinase Plasminogen Activator) |
| تواريخ الأحداث: | Date Created: 20220324 Date Completed: 20220829 Latest Revision: 20240216 |
| رمز التحديث: | 20240216 |
| مُعرف محوري في PubMed: | PMC9129107 |
| DOI: | 10.1093/cid/ciac224 |
| PMID: | 35323932 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1537-6591 |
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| DOI: | 10.1093/cid/ciac224 |