Development of an innovative technology for predicting the course of COVID-19 based on the analysis of clinical and anamnestic data
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Abstract
The aim – to determine a prognostically significant set of anamnestic (primarily cardiovascular) risk factors and indicators of the initial clinical condition in the population of patients with COVID-19, on the basis of which to develop a scale for assessing the clinical condition to identify patients with a more severe subsequent course of the disease for the individualization of treatment tactics.
Materials and methods. The retrospective analysis included data on 104 patients with COVID-19 (50 men and 54 women, aged 24 to 84 years), who during 2020-2021 underwent treatment (16 days) in clinics of Ukraine within the framework of the program for studying the effectiveness of treatment COVID-19. Risk factors (advanced age, inflammatory diseases, hypertension, obesity, diabetes, coronary heart disease, heart failure (HF)), dynamics of the clinical state (heart rate, body temperature, blood pressure, SpO2, respiratory rate (RR), clinical symptoms and signs from all systems of the body) were assessed. Based on the dynamics of the clinical condition (according to a specially developed scale), all patients were divided into subgroup A (66 patients, more severe hospital course of COVID-19, ≥ 7 points) and subgroup B (38 patients, milder course of COVID-19, < 7) points).
Results and discussion. Among the anamnestic risk factors (RF) of a more severe hospitalization for COVID-19, the following were more informative than others: age > 53 years (HR 1.8 (1.11–3.02)), history of coronary artery disease (HR 1.42 (1.09–1.85)) and SN (HR 1.67 (1.41–1.96)), as well as a model built taking into account all the estimated RFs according to their significance (HR = 1.88 (1.37–2.74), area under the ROC curve (ROC) 0.73). Among the clinical markers (CM) of the first day, the most informative were: RR > 20/min (HR 1.74 (1.10–2.74)), body temperature > 37.8 °C (HR 1.48 (1.13–1.94)) and a model with eight KM (HR 2.45 (1.55–3.87), ROC 0.80). The obtained scales were additive: the combined scale of RF and CM had ROC 0.84, value > 21 units on the first day of COVID-19 had a sensitivity of 76 % and a specificity of 76 % (HR 2.38 (1.58–3.58)) in predicting the adverse course of the disease during the next 16 days.
Conclusions. The risk assessment system developed by us, based on clinical and anamnestic data, on the first day of treatment for COVID-19 allows predicting a more severe course of the disease. The data obtained by us require further study in a prospective study.
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