Below please find a summary and link(s) of new coronavirus-related content published today in Annals of Internal Medicine. The summary below is not intended to substitute for the full article as a source of information. A collection of coronavirus-related content is free to the public at http://go.annals.org/coronavirus.
Prediction model uses patient data at admission to determine potential disease trajectory for COVID-19 patients
Older age and obesity independent risk factors for severe disease and death
Data can be used to determine resource allocation and care decisions
Data collected from participants upon hospital admission at a single health care system were used to develop a decision tool called the COVID-19 Inpatient Risk Calculator (CIRC). This prediction model proved accurate at determining potential disease trajectory, or whether a patient's disease would worsen while being treated in the hospital and at what point in their care that might happen. Older age and obesity were found to be independent risk factors for progression of COVID-19 to severe disease or death. Findings from a cohort study are published in Annals of Internal Medicine.
Researchers from Johns Hopkins University School of Medicine and Johns Hopkins Bloomberg School of Public Health reviewed 827 consecutive COVID-19 admissions in five Maryland and Washington, D.C. area hospitals to determine the factors on hospital admission that are predictive of severe disease or death from COVID-19. Among the risk factors researchers considered as part of the model were a patient's age, body mass index (BMI), lung health and chronic disease, as well as vital signs and the severity of a patient's COVID-19 symptoms at the time of admission. The researchers found that 90 percent of deaths occurred in patients 60 years and older. Other risk factors included older age and living in a nursing home, especially in patients over 70. BMI, independent of age, was also associated with progression to severe disease or death. The researchers noted how quickly patients could progress to severe illnesses when patients had all or some of the risk factors.
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The CIRC proved very accurate at predicting severe disease progression and can be used to inform clinical and resource allocation decisions. An interactive version of the CIRC is available at https://rsconnect.biostat.jhsph.edu/covid_predict/. The authors suggest that this study has its limitations, as it was done in a single health care system. Read the full text: https://www.acpjournals.org/doi/10.7326/M20-3905.
Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The lead authors, Brian T. Garibaldi, MD, MEHP, and Jacob Fiksel, PhD, can be reached through Patrick Smith at psmith88@jhmi.edu or 410-955-8242.
Journal
Annals of Internal Medicine