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Prognostic Nutritional Index for COVID-19 Prognosis and a New Pre-Prediction Scoring Model for In- Hospital Mortality: Experiences from Turkey, Single Center Retrospective Cohort Analysis
23 Pages Posted: 30 Jul 2020
More...Abstract
Background: Although many studies reported prognostic factors proceeding to severity of COVID-19 patients, in none of the article a prediction scoring model has been proposed. In this article a new prediction tool is presented in combination of Turkish experince during pandemic.
Methods: Laboratory and clinical data of 397 over 798 confirmed COVID-19 patients from Gulhane Training and Research Hospital electronic medical record system were included into this retrospective cohort study between the dates of 23 March to 18 May, 2020. Patient demograhics, peripheral venous blood parameters, symptoms at admission, in hospital mortality data were collected. Non-survivor and survivor pateints were compared to find out a prediction scoring model for mortality.
Results: There was 34 [8.56% (95% CI:0.06-0.11)] mortality during study period. Mean age of patients was 57.1±16.7 years. Older age, comorbid diseases, symptoms such as fever, dyspnea, fatigue and gastrointestinal and WBC, neutrophil, lymphocyte count, C-reactive protein, neutrophil-to-lymphocyte ratio of patients in non-survivors were significantly higher. Univariate analysis demonstrated that OR for prognostic nutritional index (PNI) tertile 1 was 18.57 (95% CI=4.39-78.65, p<0.05) compared to tertile 2. Performance statistics of prediction scoring method showed 98% positive predictive value for criteria 1.
Conclusions: It is crucial to constitute prognostic clinical and laboratory parameters for faster delineate patients who are prone to worse prognosis. Suggested prediction scoring method may guide healthcare professional to discriminate severe COVID-19 patients and provide prompt intensive therapies which is highly important due to rapid progression leading to mortality.
Funding Statement: This research received no specific no grant from any funding agency in the public, commercial, or not for profit sectors.
Declaration of Interests: The authors declare that they have no conflict of interest.
Ethics Approval Statement: This retrospective cohort study was approved by Ethics Committee of Health Sciences University, Gulhane School of Medicine (2020-152) and conducted in line with ethical standards of Declaration of Helsinki. Confirmed COVID-19 cases from 23 March to 18 May, 2020 were included consecutively. Anonymous clinical and laboratory findings were collected. Therefore, there was no requirement for informed consent.
Keywords: COVID-19; Prognostic Nutritional Index; Hospital Mortality; Neutrophil-to-Lymphocyte ratio; Prognosis; Mortality Prediction Model; High Sensitive-Modified Glasgow Prognostic Score
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