ANDC: an early warning score to predict mortality risk for patients with Coronavirus Disease 2019
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Journal of Translational Medicine Open Access
RESEARCH
ANDC: an early warning score to predict mortality risk for patients with Coronavirus Disease 2019 Zhihong Weng1,2† , Qiaosen Chen3†, Sumeng Li1, Huadong Li4, Qian Zhang1, Sihong Lu1, Li Wu5, Leiqun Xiong6, Bobin Mi7, Di Liu8, Mengji Lu2,9, Dongliang Yang1,2, Hongbo Jiang3*†, Shaoping Zheng10*† and Xin Zheng1,2*†
Abstract Background: Patients with severe Coronavirus Disease 2019 (COVID-19) will progress rapidly to acute respiratory failure or death. We aimed to develop a quantitative tool for early predicting mortality risk of patients with COVID-19. Methods: 301 patients with confirmed COVID-19 admitted to Main District and Tumor Center of the Union Hospital of Huazhong University of Science and Technology (Wuhan, China) between January 1, 2020 to February 15, 2020 were enrolled in this retrospective two-centers study. Data on patient demographic characteristics, laboratory findings and clinical outcomes was analyzed. A nomogram was constructed to predict the death probability of COVID-19 patients. Results: Age, neutrophil-to-lymphocyte ratio, d-dimer and C-reactive protein obtained on admission were identified as predictors of mortality for COVID-19 patients by LASSO. The nomogram demonstrated good calibration and discrimination with the area under the curve (AUC) of 0.921 and 0.975 for the derivation and validation cohort, respectively. An integrated score (named ANDC) with its corresponding death probability was derived. Using ANDC cut-off values of 59 and 101, COVID-19 patients were classified into three subgroups. The death probability of low risk group (ANDC 101) was more than 50%, respectively. Conclusion: The prognostic nomogram exhibited good discrimination power in early identification of COVID-19 patients with high mortality risk, and ANDC score may help physicians to optimize patient stratification management. Keywords: SARS-Cov-2, COVID-19, Nomogram, Mortality, Risk factor
*Correspondence: [email protected]; [email protected]; [email protected] † Zhihong Weng and Qiaosen Chen contributed equally to this work † Hongbo Jiang, Shaoping Zheng and Xin Zheng contributed equally to this work 1 Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan 430022, China 3 Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Road, Guangzhou 510310, China 10 Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan 430022, China Full list of author information is available at the end of the article
Introduction Since December 2019, Coronavirus Disease 2019 (COVID-19), a newly recognized illness caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV-2), formerly named 2019-nCoV-infected pneumonia (NCIP) broke out in Wuhan (Hubei, China) and rapidly spread throughout China and other regions of the world
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