AUTHOR=Ma Xiaoxu , Li Ang , Jiao Mengfan , Shi Qingmiao , An Xiaocai , Feng Yonghai , Xing Lihua , Liang Hongxia , Chen Jiajun , Li Huiling , Li Juan , Ren Zhigang , Sun Ranran , Cui Guangying , Zhou Yongjian , Cheng Ming , Jiao Pengfei , Wang Yu , Xing Jiyuan , Shen Shen , Zhang Qingxian , Xu Aiguo , Yu Zujiang 

TITLE=Characteristic of 523 COVID-19 in Henan Province and a Death Prediction Model

JOURNAL=Frontiers in Public Health

VOLUME=Volume 8 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2020.00475

DOI=10.3389/fpubh.2020.00475

ISSN=2296-2565

ABSTRACT=Certain high-risk factors related to the death of COVID-19 have been reported, however, there were few studies on a death prediction model. This study was conducted to delineate the clinical characteristics of patients with coronavirus disease 2019 (covid-19) of different degree and establish a death prediction model. In this multi-centered, retrospective, observational study, we enrolled 523 COVID-19 cases discharged before February 20, 2020 in Henan Province, China, compared clinical data, screened for high-risk fatal factors, built a death prediction model and validated the model in 429 mild cases, 6 fatal cases discharged after February 16, 2020 from Henan and 14 cases from Wuhan. Out of the 523 cases, 429 were mild, 78 severe survivors, 16 non-survivors. The non-survivors with median age 71 were older and had more comorbidities than the mild and severe survivors. Non-survivors had a relatively delay in hospitalization, with higher white blood cell count, neutrophil percentage, D-dimer, LDH, BNP and PCT levels and lower proportion of eosinophils, lymphocytes and albumin. Discriminative models were constructed by using random forest with 16 non-survivors and 78 severe survivors. Age was the leading risk factors for poor prognosis, with AUC of 0·907 (95% CI 0·831-0·983). Mixed model constructed with combination of age, demographics, symptoms and laboratory findings at admission had better performance (p= 0.021) with a generalized AUC of 0·9852 (95% CI 0·961-1). We chose 0·441 as death prediction threshold (with 0·85 sensitivity and 0·987 specificity) and validated the model in 429 mild cases, 6 fatal cases discharged after February 16, 2020 from Henan and 14 cases from Wuhan successfully. Mixed model can accurately predict clinical outcomes of COVID-19 patients.