Early prediction of disease progression in COVID-19 pneumonia patients with chest CT and clinical characteristics
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Abstract
The outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread to become a worldwide emergency. Early identification of patients at risk of progression may facilitate more individually aligned treatment plans and optimized utilization of medical resource. Here we conducted a multicenter retrospective study involving patients with moderate COVID-19 pneumonia to investigate the utility of chest computed tomography (CT) and clinical characteristics to risk-stratify the patients. Our results show that CT severity score is associated with inflammatory levels and that older age, higher neutrophil-to-lymphocyte ratio (NLR), and CT severity score on admission are independent risk factors for short-term progression. The nomogram based on these risk factors shows good calibration and discrimination in the derivation and validation cohorts. These findings have implications for predicting the progression risk of COVID-19 pneumonia patients at the time of admission. CT examination may help risk-stratification and guide the timing of admission.
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SciScore for 10.1101/2020.02.19.20025296: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The permission of Institutional Review Board of The Third Xiangya Hospital was obtained for retrospective assessment of clinical and radiological data with waiver of informed consent.
Consent: The permission of Institutional Review Board of The Third Xiangya Hospital was obtained for retrospective assessment of clinical and radiological data with waiver of informed consent.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources Statistical analyses were performed using IBM SPSS statistics software (version 22.0, SPSS Inc., Chicago, IL, USA) … SciScore for 10.1101/2020.02.19.20025296: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The permission of Institutional Review Board of The Third Xiangya Hospital was obtained for retrospective assessment of clinical and radiological data with waiver of informed consent.
Consent: The permission of Institutional Review Board of The Third Xiangya Hospital was obtained for retrospective assessment of clinical and radiological data with waiver of informed consent.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources Statistical analyses were performed using IBM SPSS statistics software (version 22.0, SPSS Inc., Chicago, IL, USA) and R software (version 3.6.1). SPSSsuggested: (SPSS, RRID:SCR_002865)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There were some limitations in our study. First, our study retrospectively included 141 patients with moderate NCP on admission from one single city outside Wuhan. Data from multiple cities are needed to further validate our findings. Second, dynamic inflammatory indexes and treatment during hospitalization were not included in the analysis. More comprehensive investigation of the relationship between CT characteristics and cytokine storm induced by COVID-2019 needs to be performed. In conclusion, our results showed that higher NLR and CT severity score on admission were independent risk factors for short-term progression in patients with NCP. The CT findings in patients with NCP were associated with inflammatory levels and both them have the potential to predict disease progression. Imported and nonimported patients outside Wuhan should be managed equally, and early admission is required for avoiding severe pulmonary damage.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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