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Development and Validation of a Diagnostic Nomogram to Predict SARS-CoV-2 Pneumonia

24 Pages Posted: 1 Apr 2020

See all articles by Zhiyi Wang

Zhiyi Wang

Wenzhou Medical University - Department of Emergency Medicine and General Practice

Jie Weng

Wenzhou Medical University - Department of Emergency Medicine and General Practice

Zhongwang Li

Wenzhou Medical University - Department of Intensive Care Unit

Ruonan Hou

Wenzhou Medical University - Department of Emergency Medicine and General Practice

Lebin Zhou

People’s Hospital of Yueqing - Pulmonary and Critical Care Medicine

Hua Ye

People’s Hospital of Yueqing - Pulmonary and Critical Care Medicine

Ying Cheng

Wenzhou Medical University - Department of Emergency Medicine and General Practice

Ting Yang

Wenzhou Medical University - Department of Emergency Medicine and General Practice

Daqing Chen

Wenzhou Medical University - Department of Emergency Medicine and General Practice

Liang Wang

East Tennessee State University - Department of Biostatistics and Epidemiology

Xiaodong Liu

Wenzhou Medical University - Health Assessment Center

Xian Sheng

Wenzhou Medical University - Division of Gastrointestinal Surgery

Shengwei Jin

Wenzhou Medical University - Department of Anesthesia and Critical Care

More...

Abstract

Background: This study aimed to establish an effective diagnostic nomogram for suspected SARS-CoV-2 pneumonia patients.

Methods: We used the LASSO aggression and multivariable logistic regression methods to explore the predictive factors associated with SARS-Cov-2 pneumonia, and established the diagnostic nomogram for SARS-Cov-2 pneumonia using multivariable regression. This diagnostic nomogram was assessed by the internal and external validation data set. Further, we plotted decision curves and clinical impact curve to evaluate the clinical usefulness of this diagnostic nomogram.

Findings: The predictive factors including the epidemiological history, wedge-shaped or fan-shaped lesion parallel to or near the pleura, bilateral lower lobes, ground glass opacities, crazy paving pattern and white blood cell (WBC) count were contained in the nomogram. In the primary cohort, the C-statistic for predicting the probability of the SARS-CoV-2 pneumonia was 0.967, even higher than the C-statistic (0.961) in initial viral nucleic acid nomogram which was established using the univariable regression. The C-statistic was 0.848 in external validation cohort. Good calibration curves were observed for the prediction probability in the internal validation and external validation cohort. The nomogram both performed well in terms of discrimination and calibration. Moreover, decision curve and clinical impact curve were also beneficial for SARS-CoV-2 pneumonia patients.

Interpretation: Our nomogram can be used to predict SARS-CoV-2 pneumonia accurately and favourably.

Funding Statement: None.

Declaration of Interests: The author(s) indicated no potential conflict of interest.

Ethics Approval Statement: The study was approved by the Ethics Committee of the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University.

Suggested Citation

Wang, Zhiyi and Weng, Jie and Li, Zhongwang and Hou, Ruonan and Zhou, Lebin and Ye, Hua and Cheng, Ying and Yang, Ting and Chen, Daqing and Wang, Liang and Liu, Xiaodong and Sheng, Xian and Jin, Shengwei, Development and Validation of a Diagnostic Nomogram to Predict SARS-CoV-2 Pneumonia (3/20/2020). Available at SSRN: https://ssrn.com/abstract=3559564 or http://dx.doi.org/10.2139/ssrn.3559564

Zhiyi Wang (Contact Author)

Wenzhou Medical University - Department of Emergency Medicine and General Practice ( email )

Wenzhou
China

Jie Weng

Wenzhou Medical University - Department of Emergency Medicine and General Practice

China

Zhongwang Li

Wenzhou Medical University - Department of Intensive Care Unit

China

Ruonan Hou

Wenzhou Medical University - Department of Emergency Medicine and General Practice

China

Lebin Zhou

People’s Hospital of Yueqing - Pulmonary and Critical Care Medicine ( email )

Wenzhou
China

Hua Ye

People’s Hospital of Yueqing - Pulmonary and Critical Care Medicine

Wenzhou
China

Ying Cheng

Wenzhou Medical University - Department of Emergency Medicine and General Practice

China

Ting Yang

Wenzhou Medical University - Department of Emergency Medicine and General Practice ( email )

China

Daqing Chen

Wenzhou Medical University - Department of Emergency Medicine and General Practice

China

Liang Wang

East Tennessee State University - Department of Biostatistics and Epidemiology ( email )

TN
United States

Xiaodong Liu

Wenzhou Medical University - Health Assessment Center ( email )

Wenzhou, 325035
China

Xian Sheng

Wenzhou Medical University - Division of Gastrointestinal Surgery ( email )

China

Shengwei Jin

Wenzhou Medical University - Department of Anesthesia and Critical Care ( email )

Wenzhou
China

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