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New Models Predict Risk for Ventilation, Death From COVID-19

MONDAY, March 8, 2021 -- Two new models help predict which hospitalized COVID-19 patients will require mechanical ventilation or die, according to a study published online Feb. 25 in EClinicalMedicine.

Christopher J. Nicholson, Ph.D., from Massachusetts General Hospital in Boston, and colleagues used electronic medical records to retrospectively identify 1,042 patients with COVID-19 (median age, 64 years; 56.8 percent male) admitted to Mass General Brigham hospitals before May 19, 2020, to determine risk factors on admission (including comorbidities, vital signs, and initial laboratory assessment) associated with the need for ventilation and in-hospital mortality. The Ventilation in COVID Estimator (VICE) and Death in COVID Estimator (DICE) risk scores were derived from 578 patients and validated among 464 patients.

The researchers identified four factors independently predictive for mechanical ventilation (diabetes mellitus, oxygen saturation to fraction of inspired oxygen ratio, C-reactive protein, and lactate dehydrogenase) and 10 factors predictive of in-hospital mortality (age, male sex, coronary artery disease, diabetes mellitus, chronic statin use, oxygen saturation to fraction of inspired oxygen ratio, body mass index, neutrophil-to-lymphocyte ratio, platelet count, and procalcitonin). The VICE and DICE risk scores performed with C-statistics of 0.84 and 0.91, respectively. The chronic use of a statin was associated with protection against death due to COVID-19.

"The risk scores developed in this study may help clinicians more appropriately determine which COVID-19 patients will need to be managed with greater intensity," the authors write.

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