Covidogram as a simple tool for predicting severe course of COVID-19: population-based study

• Published in: BMJ open 2021-02, Vol.11 (2), p.e045442
• Main Authors: Jarkovsky, Jiri, Benesova, Klara, Cerny, Vladimir, Razova, Jarmila, Kala, Petr, Dolina, Jiri, Majek, Ondrej, Sebestova, Silvie, Bezdekova, Monika, Melicharova, Hana, Snajdrova, Lenka, Dusek, Ladislav, Parenica, Jiri
• Format: Article
• Language: English
• Subjects: Adult; Age; Aged; Aged, 80 and over; Asymptomatic; Calibration; Coronaviruses; COVID-19; Czech Republic; Data collection; Epidemiology; Female; gastroduodenal disease; Health insurance; Health services; Humans; Infectious diseases; Information systems; Intensive care; Laboratories; Male; Medical prognosis; Middle Aged; organisation of health services; Patients; Population; Population-based studies; Public health; Reproducibility of Results; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Statistical analysis; Ventilators
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2020-045442

ObjectivesCOVID-19 might either be entirely asymptomatic or manifest itself with a large variability of disease severity. It is beneficial to identify early patients with a high risk of severe course. The aim of the analysis was to develop a prognostic model for the prediction of the severe course of acute respiratory infection.DesignA population-based study.SettingCzech Republic.ParticipantsThe first 7455 consecutive patients with COVID-19 who were identified by reverse transcription-PCR testing from 1 March 2020 to 17 May 2020.Primary outcomeSevere course of COVID-19.ResultOf a total 6.2% of patients developed a severe course of COVID-19. Age, male sex, chronic kidney disease, chronic obstructive pulmonary disease, recent history of cancer, chronic heart failure, acid-related disorders treated with proton-pump inhibitors and diabetes mellitus were found to be independent negative prognostic factors (Area under the ROC Curve (AUC) was 0.893). The results were visualised by risk heat maps, and we called this diagram a ‘covidogram’. Acid-related disorders treated with proton-pump inhibitors might represent a negative prognostic factor.ConclusionWe developed a very simple prediction model called ‘covidogram’, which is based on elementary independent variables (age, male sex and the presence of several chronic diseases) and represents a tool that makes it possible to identify—with a high reliability—patients who are at risk of a severe course of COVID-19. Obtained results open clinically relevant question about the role of acid-related disorders treated by proton-pump inhibitors as predictor for severe course of COVID-19.