What are the Strongest Predictors of COVID-19 Hospitalization and Critical Illness?
BACKGROUND AND PURPOSE:
Petrilli et al. (medRxiv, 2020; preprint) describe characteristics associated with hospitalization and severe illness for COVID-19 patients in New York City and Long Island
Academic health system in New York City (March 1, 2020 to April 2, 2020 | follow up through April 7, 2020)
All patients with COVID-19 (laboratory confirmed)
Statistical analysis: Predictive modeling performed using two different approaches
Multivariable logistic regression used to identify key risk factors
Maximum information gain (splitting) decision tree classifications were constructed for hospital admission and severe complications to determine variables that best classified patients into these outcome groups
Admission oxygen saturation <88%: OR 6.9 (95% CI, 3.2 to 15.2)
D-dimer>2500: OR 6.9 (95% CI, 3.2 to 15.2)
Ferritin >2500: OR 6.9 (95% CI, 3.2 to 15.2)
C-reactive protein (CRP) >200: OR 5.78 (95% CI, 2.6 to 13.8)
The most important features for admission (using splitting decision trees)
The most important features for critical illness (using splitting decision trees)
Troponin: <0.1 (protective)
For COVID-19 patients in New York City, the strongest predictors of hospital admission were age and underlying health conditions, like obesity and heart failure | Smoking was not identified as a critical risk factor
For patients who were admitted, the strongest predictors of critical illness were hypoxia and early elevations in inflammatory markers
The authors suggest that healthcare providers routinely obtain inflammatory markers (e.g., d-dimer and CRP) for hospitalized COVID-19 patients
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan