IL-6–based mortality prediction model for COVID-19: Validation and update in multicenter and second wave cohorts - 05/05/21
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Abstract |
Background |
Coronavirus disease 2019 (COVID-19) is a highly variable condition. Validated tools to assist in the early detection of patients at high risk of mortality can help guide medical decisions.
Objective |
We sought to validate externally, as well as in patients from the second pandemic wave in Europe, our previously developed mortality prediction model for hospitalized COVID-19 patients.
Methods |
Three validation cohorts were generated: 2 external with 185 and 730 patients from the first wave and 1 internal with 119 patients from the second wave. The probability of death was calculated for all subjects using our prediction model, which includes peripheral blood oxygen saturation/fraction of inspired oxygen ratio, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, IL-6, and age. Discrimination and calibration were evaluated in the validation cohorts. The prediction model was updated by reestimating individual risk factor effects in the overall cohort (N = 1477).
Results |
The mortality prediction model showed good performance in the external validation cohorts 1 and 2, and in the second wave validation cohort 3 (area under the receiver-operating characteristic curve, 0.94, 0.86, and 0.86, respectively), with excellent calibration (calibration slope, 0.86, 0.94, and 0.79; intercept, 0.05, 0.03, and 0.10, respectively). The updated model accurately predicted mortality in the overall cohort (area under the receiver-operating characteristic curve, 0.91), which included patients from both the first and second COVID-19 waves. The updated model was also useful to predict fatal outcome in patients without respiratory distress at the time of evaluation.
Conclusions |
This is the first COVID-19 mortality prediction model validated in patients from the first and second pandemic waves. The COR+12 online calculator is freely available to facilitate its implementation (COR12_Score/).
Le texte complet de cet article est disponible en PDF.Key words : COVID-19, IL-6, mortality risk, predictive model, second wave, external validation
Abbreviations used : ARDS, AUC, COVID-19, ER, ICU, LDH, N/L, SpO2/FiO2
Plan
| This study was supported by the Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation (COVID-19 research call COV20/00181)—cofinanced by the European Development Regional Fund “A way to achieve Europe.” R.L.-G. holds a research contract “Rio Hortega” (CM19/00120), B.A. a research contract “Juan Rodes” (JR17/00020), and M.F.-R., P.M., and M.C. a research contract “Miguel Servet” (CP18/00073, CP16/00116, and CP17/00006, respectively), all from the Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation. R.L.-R. is sponsored by the IIS-Fundación Jiménez Díaz-UAM Genomic Medicine Chair. |
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| Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest. |
Vol 147 - N° 5
P. 1652 - mai 2021 Retour au numéro
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