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ORIGINAL RESEARCH article

Front. Med.

Sec. Geriatric Medicine

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1597082

This article is part of the Research TopicExploring SARS-CoV-2 Interactions in Aging and Comorbid PopulationsView all 3 articles

Predictive Model for Coronavirus Disease 2019 Severity Based on Blood Biomarkers: A Retrospective Study

Provisionally accepted
Xiaoyan  LiuXiaoyan Liu1zhongying  Baozhongying Bao1Shuhong  DuanShuhong Duan1Jing  SunJing Sun1Yijie  ZhangYijie Zhang1*Jie  ZhangJie Zhang1*Jingxin  LiuJingxin Liu2*
  • 1Beijing sijitan Hospital, Beijing, China
  • 2Soochow University, Suzhou, Jiangsu Province, China

The final, formatted version of the article will be published soon.

Objective: To develop and validate a clinical prediction model for assessing the severity of Coronavirus Disease 2019 (COVID-19) using blood biomarkers, aiming to support clinical decisionmaking and treatment guidance.: A retrospective cohort study was conducted at Beijing Shijitan Hospital on January 5, 2023, including SARS-CoV-2 positive patients with initial chest CT-detected pneumonia 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. Results: The study included 1007 patients, with 778 in the training set and 229 in the validation set. The C-reactive protein (CRP), NE, 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.The 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.

Keywords: COVID-19, severity, blood biomarkers, predictive model, Retrospective cohort analysis

Received: 20 Mar 2025; Accepted: 18 Jul 2025.

Copyright: © 2025 Liu, Bao, Duan, Sun, Zhang, Zhang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Yijie Zhang, Beijing sijitan Hospital, Beijing, China
Jie Zhang, Beijing sijitan Hospital, Beijing, China
Jingxin Liu, Soochow University, Suzhou, 215000, Jiangsu Province, China

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