- The COVID-GRAM web-based calculator offers an estimate of individual patient risk for developing severe illness.
- Risk score predictors: chest radiography abnormality (CXR), age, hemoptysis, dyspnea, unconsciousness, number of comorbidities, cancer history, neutrophil/lymphocyte ratio (NLR, 0-80), lactate dehydrogenase (0-1500 µL), direct bilirubin (0-24 µmol/L).
- Risk calculator accuracy is 0.88.
Why this matters
- Accurate identification of who is at highest risk for severe disease could greatly aid clinical management, patient counseling, and resource use.
- Risk score is based on 10 independent, validated predictors.
- Development cohort: 1590 patients, mean (standard deviation [SD]) age 48.9 (15.7) years, 57.3% (n=904) male.
- Logistic analysis identified 10/72 variables independently/significantly predictive (ORs) of critical illness:
- Unconsciousness: 4.71 (P=.01).
- Hemoptysis: 4.53 (P=.01).
- Cancer history: 4.07 (P=.02).
- CXR abnormality: 3.39 (P<.001>
- Dyspnea: 1.88 (P=.01).
- Comorbidities (number): 1.60 (P<.001>
- Direct bilirubin: 1.15 (P=.001).
- NLR: 1.06 (P=.003).
- Age: 1.03 (P=.002).
- Lactate dehydrogenase: 1.002 (P<.001>
- Validation cohort: 710 patients, mean (SD) age 48.2 (15.2) years, 53.8% (382) men.
- Mean area under the curve: 0.88 (95% CI, 0.85-0.91; P<.001>
- Retrospective nationwide cohort analysis of epidemiological, clinical characteristics associated with developing critical COVID-19 illness to construct a risk prediction score.
- Funding: China National Science Foundation.
- Modest sample size.
- Limited generalizability.