Predictive model for coronavirus disease 2019 severity based on blood biomarkers: a retrospective study

ObjectiveTo develop and validate a clinical prediction model for assessing the severity of coronavirus disease 2019 (COVID-19) using blood biomarkers, aiming to support clinical decision-making and treatment guidance.MethodsA retrospective cohort study was conducted at Beijing Shijitan Hospital on J...

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Main Authors: Liu Xiaoyan, Bao Zhongying, Duan Shuhong, Sun Jing, Zhang Yijie, Zhang Jie, Liu Jingxin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1597082/full
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author Liu Xiaoyan
Bao Zhongying
Duan Shuhong
Sun Jing
Zhang Yijie
Zhang Jie
Liu Jingxin
author_facet Liu Xiaoyan
Bao Zhongying
Duan Shuhong
Sun Jing
Zhang Yijie
Zhang Jie
Liu Jingxin
author_sort Liu Xiaoyan
collection DOAJ
description ObjectiveTo develop and validate a clinical prediction model for assessing the severity of coronavirus disease 2019 (COVID-19) using blood biomarkers, aiming to support clinical decision-making and treatment guidance.MethodsA retrospective cohort study was conducted at Beijing Shijitan Hospital on January 5, 2023, including SARS-CoV-2 positive patients with initial chest CT-detected from outpatient and emergency departments. Data on demographics, symptoms, and blood biomarkers were collected. Patients were categorized into non-severe (mild and moderate) and severe (severe and critical) groups based on clinical symptoms and disease progression. Outpatient data served as the training set for modeling and validation using logistic regression and 10-fold cross validation. Emergency department data functioned as an independent external validation set to test the model’s generalizability.ResultsThe study included 1,007 patients, with 778 in the training set and 229 in the validation set. The C-reactive protein (CRP), neutrophil count (NE), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) were significantly higher in the severe COVID-19 group, while lymphocyte count (LY) and eosinophil count (EO) were significantly lower in the non-severe group (p < 0.001). The predictive model integrating these factors exhibited high discriminative power, achieving an AUC of 0.85, accuracy of 0.80, sensitivity of 0.73, and specificity of 0.81 in 10-fold cross validation, and an AUC of 0.86, accuracy of 0.82, sensitivity of 0.60, and specificity of 0.90 in the validation set.ConclusionThe predictive model, informed by blood biomarkers, successfully discriminates against COVID-19 patients at higher risk for severe outcomes, offering a valuable tool for clinical management and resource optimization.
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spelling doaj-art-64fd1fc4c6cf430199a24d39b59641ac2025-08-20T03:59:32ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-08-011210.3389/fmed.2025.15970821597082Predictive model for coronavirus disease 2019 severity based on blood biomarkers: a retrospective studyLiu Xiaoyan0Bao Zhongying1Duan Shuhong2Sun Jing3Zhang Yijie4Zhang Jie5Liu Jingxin6Department of Infectious Diseases, Beijing Shijitan Hospital, Capital Medical University, Beijing, ChinaDepartment of Infectious Diseases, Beijing Shijitan Hospital, Capital Medical University, Beijing, ChinaDepartment of Infectious Diseases, Beijing Shijitan Hospital, Capital Medical University, Beijing, ChinaDepartment of Infectious Diseases, Beijing Shijitan Hospital, Capital Medical University, Beijing, ChinaDepartment of Emergency, Beijing Shijitan Hospital, Capital Medical University, Beijing, ChinaDepartment of Infectious Diseases, Beijing Shijitan Hospital, Capital Medical University, Beijing, ChinaPhysical Education and Sports School, Soochow University, Suzhou, Jiangsu, ChinaObjectiveTo develop and validate a clinical prediction model for assessing the severity of coronavirus disease 2019 (COVID-19) using blood biomarkers, aiming to support clinical decision-making and treatment guidance.MethodsA retrospective cohort study was conducted at Beijing Shijitan Hospital on January 5, 2023, including SARS-CoV-2 positive patients with initial chest CT-detected from outpatient and emergency departments. Data on demographics, symptoms, and blood biomarkers were collected. Patients were categorized into non-severe (mild and moderate) and severe (severe and critical) groups based on clinical symptoms and disease progression. Outpatient data served as the training set for modeling and validation using logistic regression and 10-fold cross validation. Emergency department data functioned as an independent external validation set to test the model’s generalizability.ResultsThe study included 1,007 patients, with 778 in the training set and 229 in the validation set. The C-reactive protein (CRP), neutrophil count (NE), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) were significantly higher in the severe COVID-19 group, while lymphocyte count (LY) and eosinophil count (EO) were significantly lower in the non-severe group (p < 0.001). The predictive model integrating these factors exhibited high discriminative power, achieving an AUC of 0.85, accuracy of 0.80, sensitivity of 0.73, and specificity of 0.81 in 10-fold cross validation, and an AUC of 0.86, accuracy of 0.82, sensitivity of 0.60, and specificity of 0.90 in the validation set.ConclusionThe predictive model, informed by blood biomarkers, successfully discriminates against COVID-19 patients at higher risk for severe outcomes, offering a valuable tool for clinical management and resource optimization.https://www.frontiersin.org/articles/10.3389/fmed.2025.1597082/fullCOVID-19severityblood biomarkerspredictive modelretrospective cohort analysis
spellingShingle Liu Xiaoyan
Bao Zhongying
Duan Shuhong
Sun Jing
Zhang Yijie
Zhang Jie
Liu Jingxin
Predictive model for coronavirus disease 2019 severity based on blood biomarkers: a retrospective study
Frontiers in Medicine
COVID-19
severity
blood biomarkers
predictive model
retrospective cohort analysis
title Predictive model for coronavirus disease 2019 severity based on blood biomarkers: a retrospective study
title_full Predictive model for coronavirus disease 2019 severity based on blood biomarkers: a retrospective study
title_fullStr Predictive model for coronavirus disease 2019 severity based on blood biomarkers: a retrospective study
title_full_unstemmed Predictive model for coronavirus disease 2019 severity based on blood biomarkers: a retrospective study
title_short Predictive model for coronavirus disease 2019 severity based on blood biomarkers: a retrospective study
title_sort predictive model for coronavirus disease 2019 severity based on blood biomarkers a retrospective study
topic COVID-19
severity
blood biomarkers
predictive model
retrospective cohort analysis
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1597082/full
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