Predictive performance of emergency department-specific variables on COVID-19 pneumonia
Introduction: The majority of patients with COVID-19 infection do not progress to pneumonia. We report emergency department (ED)-specific variables and evaluate their predictive performance on diagnosis of pneumonia, intensive care unit (ICU) admission and death. Methods: This was a retrospective, s...
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| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer – Medknow Publications
2022-12-01
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| Series: | Singapore Medical Journal |
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| Online Access: | https://journals.lww.com/10.11622/smedj.2021084 |
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| _version_ | 1823861036349915136 |
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| author | Hann-Yee Tan Mathew Yeo Xin-Ying Tay Michael Fung Ranjeev Kumar Say-Tat Ooi Lina Amirah Chalani Udhyami Ubeynarayana Desmond Mao |
| author_facet | Hann-Yee Tan Mathew Yeo Xin-Ying Tay Michael Fung Ranjeev Kumar Say-Tat Ooi Lina Amirah Chalani Udhyami Ubeynarayana Desmond Mao |
| author_sort | Hann-Yee Tan |
| collection | DOAJ |
| description | Introduction:
The majority of patients with COVID-19 infection do not progress to pneumonia. We report emergency department (ED)-specific variables and evaluate their predictive performance on diagnosis of pneumonia, intensive care unit (ICU) admission and death.
Methods:
This was a retrospective, single-centre cohort study of confirmed COVID-19 patients admitted to a Singapore tertiary hospital. Primary outcome was diagnosis of COVID-19 pneumonia. Secondary outcomes were ICU admission and/or death. Multivariate logistic regression was used to analyse the predictive performance of ED-specific variables. Accuracy of continuous variables was measured by area under receiver operating characteristic (ROC) curve.
Results:
294 patients were included. Patients with pneumonia were older (52.0 years, P < 0.001) and had higher C-reactive protein (CRP; 33.8 mg/L, P < 0.001). Patients with indeterminate chest radiograph (CRX) findings were at risk of pneumonia vs. patients with normal CRX (37.5% vs. 4.3%, P < 0.001). Patients admitted to ICU were older (60.0 years, P < 0.001) and had higher CRP (40.0 mg/L, P < 0.001). Diagnosis of COVID-19 pneumonia was associated with ICU admission and death (30.0% vs 0.39%, P < 0.001). Multivariate logistic regression analysis showed that age (aOR 1.07, P = 0.049), CRP (aOR 1.05, P = 0.006) and CRX findings (aOR 50.00, P < 0.001) had increased odds of pneumonia. ROC curve analysis showed that CRP of 23.3 mg/L was the optimal cut-off for predicting pneumonia.
Conclusion:
Older age, higher CRP and CRX findings are associated with COVID-19 pneumonia, ICU admission and death. Prospective studies should be undertaken to validate these findings. |
| format | Article |
| id | doaj-art-80899f23f29141338ffd6dfb173e5761 |
| institution | Kabale University |
| issn | 0037-5675 2737-5935 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | Wolters Kluwer – Medknow Publications |
| record_format | Article |
| series | Singapore Medical Journal |
| spelling | doaj-art-80899f23f29141338ffd6dfb173e57612025-02-10T05:48:52ZengWolters Kluwer – Medknow PublicationsSingapore Medical Journal0037-56752737-59352022-12-01631271572210.11622/smedj.2021084Predictive performance of emergency department-specific variables on COVID-19 pneumoniaHann-Yee TanMathew YeoXin-Ying TayMichael FungRanjeev KumarSay-Tat OoiLina AmirahChalani Udhyami UbeynarayanaDesmond MaoIntroduction: The majority of patients with COVID-19 infection do not progress to pneumonia. We report emergency department (ED)-specific variables and evaluate their predictive performance on diagnosis of pneumonia, intensive care unit (ICU) admission and death. Methods: This was a retrospective, single-centre cohort study of confirmed COVID-19 patients admitted to a Singapore tertiary hospital. Primary outcome was diagnosis of COVID-19 pneumonia. Secondary outcomes were ICU admission and/or death. Multivariate logistic regression was used to analyse the predictive performance of ED-specific variables. Accuracy of continuous variables was measured by area under receiver operating characteristic (ROC) curve. Results: 294 patients were included. Patients with pneumonia were older (52.0 years, P < 0.001) and had higher C-reactive protein (CRP; 33.8 mg/L, P < 0.001). Patients with indeterminate chest radiograph (CRX) findings were at risk of pneumonia vs. patients with normal CRX (37.5% vs. 4.3%, P < 0.001). Patients admitted to ICU were older (60.0 years, P < 0.001) and had higher CRP (40.0 mg/L, P < 0.001). Diagnosis of COVID-19 pneumonia was associated with ICU admission and death (30.0% vs 0.39%, P < 0.001). Multivariate logistic regression analysis showed that age (aOR 1.07, P = 0.049), CRP (aOR 1.05, P = 0.006) and CRX findings (aOR 50.00, P < 0.001) had increased odds of pneumonia. ROC curve analysis showed that CRP of 23.3 mg/L was the optimal cut-off for predicting pneumonia. Conclusion: Older age, higher CRP and CRX findings are associated with COVID-19 pneumonia, ICU admission and death. Prospective studies should be undertaken to validate these findings.https://journals.lww.com/10.11622/smedj.2021084covid-19c-reactive proteinemergency departmentpneumoniasars-cov-2 infection |
| spellingShingle | Hann-Yee Tan Mathew Yeo Xin-Ying Tay Michael Fung Ranjeev Kumar Say-Tat Ooi Lina Amirah Chalani Udhyami Ubeynarayana Desmond Mao Predictive performance of emergency department-specific variables on COVID-19 pneumonia Singapore Medical Journal covid-19 c-reactive protein emergency department pneumonia sars-cov-2 infection |
| title | Predictive performance of emergency department-specific variables on COVID-19 pneumonia |
| title_full | Predictive performance of emergency department-specific variables on COVID-19 pneumonia |
| title_fullStr | Predictive performance of emergency department-specific variables on COVID-19 pneumonia |
| title_full_unstemmed | Predictive performance of emergency department-specific variables on COVID-19 pneumonia |
| title_short | Predictive performance of emergency department-specific variables on COVID-19 pneumonia |
| title_sort | predictive performance of emergency department specific variables on covid 19 pneumonia |
| topic | covid-19 c-reactive protein emergency department pneumonia sars-cov-2 infection |
| url | https://journals.lww.com/10.11622/smedj.2021084 |
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