In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 6 ( 2022-6-16), p. e0270111-
Abstract:
COVID-19 prognostic factors include age, sex, comorbidities, laboratory and imaging findings, and time from symptom onset to seeking care. Purpose The study aim was to evaluate indices combining disease severity measures and time from disease onset to predict mortality of COVID-19 patients admitted to the emergency department (ED). Materials and methods All consecutive COVID-19 patients who underwent both computed tomography (CT) and chest X-ray (CXR) at ED presentation between 27/02/2020 and 13/03/2020 were included. CT visual score of disease extension and CXR Radiographic Assessment of Lung Edema (RALE) score were collected. The CT- and CXR-based scores, C-reactive protein (CRP), and oxygen saturation levels (sO 2 ) were separately combined with time from symptom onset to ED presentation to obtain severity/time indices. Multivariable regression age- and sex-adjusted models without and with severity/time indices were compared. For CXR-RALE, the models were tested in a validation cohort. Results Of the 308 included patients, 55 (17.9%) died. In multivariable logistic age- and sex-adjusted models for death at 30 days, severity/time indices showed good discrimination ability, higher for imaging than for laboratory measures (AUC CT = 0.92, AUC CXR = 0.90, AUC CRP = 0.88, AUC sO2 = 0.88). AUC CXR was lower in the validation cohort (0.79). The models including severity/time indices performed slightly better than models including measures of disease severity not combined with time and those including the Charlson Comorbidity Index, except for CRP-based models. Conclusion Time from symptom onset to ED admission is a strong prognostic factor and provides added value to the interpretation of imaging and laboratory findings at ED presentation.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0270111
DOI:
10.1371/journal.pone.0270111.g001
DOI:
10.1371/journal.pone.0270111.g002
DOI:
10.1371/journal.pone.0270111.g003
DOI:
10.1371/journal.pone.0270111.t001
DOI:
10.1371/journal.pone.0270111.t002
DOI:
10.1371/journal.pone.0270111.t003
DOI:
10.1371/journal.pone.0270111.s001
DOI:
10.1371/journal.pone.0270111.s002
DOI:
10.1371/journal.pone.0270111.s003
DOI:
10.1371/journal.pone.0270111.s004
DOI:
10.1371/journal.pone.0270111.s005
DOI:
10.1371/journal.pone.0270111.r001
DOI:
10.1371/journal.pone.0270111.r002
DOI:
10.1371/journal.pone.0270111.r003
DOI:
10.1371/journal.pone.0270111.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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