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A nomogram to early predict isolation length for non-severe COVID-19 patients based on laboratory investigation: A multicenter retrospective study in Zhejiang Province, China

Authors :
Jun Zhang
Jiangnan Chen
Yan Xia
Wei Zheng
Xinyou Xie
Shijin Yuan
Xiaoping Xu
Yan Zhang
Source :
Clinica Chimica Acta, Clinica Chimica Acta; International Journal of Clinical Chemistry
Publication Year :
2021
Publisher :
Elsevier BV, 2021.

Abstract

Highlights • Non-severe COVID-19 patients have abnormal laboratory investigations. • Patients with prolonged pretreatment APTT have a longer isolation length. • Patients with elevated eosinophils after treatment have a shorter isolation length. • A nomogram could help to predict isolation probability at 11-, 16- and 21-day.<br />Background Majority coronavirus disease 2019 (COVID-19) patients are classified as mild and moderate (non-severe) diseases. We aim to develop a model to predict isolation length for non-severe patients. Methods Among 188 non-severe patients, 96 patients were enrolled as training cohort to identify factors associated with isolation length via Cox regression model and develop a nomogram. Other 92 patients formed as validation cohort to validate nomogram. Concordance index (C-index), area under the curve (AUC) and calibration curves were used to evaluated nomogram. Results Increasing absolute eosinophil count (AEC) after admission was correlated with shorter isolation length (P = 0.02). Baseline activated partial thromboplastin time (APTT) > 30 s was correlated with longer isolation length (P = 0.03). A nomogram to predict isolation probability at 11-, 16- and 21-day was developed and validated. The C-indices of training and validation cohort were 0.604 and 0.682 respectively. Both cohorts showed a good discriminative ability (AUC, 11-day: 0.646 vs 0.730; 16-day: 0.663 vs 0.750; 21-day: 0.711 vs 0.783; respectively) and calibration power. Conclusions Baseline APTT and dynamic change of AEC were two significant factors associated with isolation length of non-severe patients. Nomogram could predict isolation probability for each patient to estimate appropriate quarantine length.

Subjects

Subjects :
Male
0301 basic medicine
Time Factors
Clinical Biochemistry
AST, aspartate aminotransferase
SII, systemic immune-inflammation index
Biochemistry
Nomogram
AUC, area under the curve
Leukocyte Count
MERS-CoV, middle east respiratory syndrome coronavirus
COVID-19 Testing
0302 clinical medicine
WBC, white blood cell count
RBC, red blood cell count
AMC, absolute monocyte count
COVID-19, coronavirus disease 2019
Isolation length
LDH, lactate dehydrogenase
medicine.diagnostic_test
Area under the curve
General Medicine
Middle Aged
PNI, prognostic nutrition index
CT, computed tomography
Hospitalization
Activated partial thromboplastin time
Area Under Curve
030220 oncology & carcinogenesis
Quarantine
CRP, C-reactive protein
Female
Partial Thromboplastin Time
Partial thromboplastin time
Adult
China
medicine.medical_specialty
Isolation (health care)
Coronavirus disease 2019 (COVID-19)
RT-PCR, reverse transcription-polymerase chain reaction
SARS-CoV, severe acute respiratory syndrome coronavirus
Physical Distancing
C-index, Concordance index
SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
Antiviral Agents
Article
WHO, World Health Organization
03 medical and health sciences
Absolute eosinophil count
ALT, alanine aminotransferase
PT, prothrombin time
Internal medicine
medicine
AEC, absolute eosinophil count
Humans
CDC, Centers for Disease Control
APTT, activated partial thromboplastin time
Proportional Hazards Models
Retrospective Studies
Biochemistry, medical
business.industry
Proportional hazards model
Biochemistry (medical)
COVID-19
ALC, absolute lymphocyte count
Reproducibility of Results
Retrospective cohort study
Ct, Cycle threshold
Training cohort
Eosinophils
Nomograms
030104 developmental biology
ANC, absolute neutrophil count
business

Details

ISSN :
00098981
Volume :
512
Database :
OpenAIRE
Journal :
Clinica Chimica Acta
Accession number :
edsair.doi.dedup.....05f7b8c31016bf4dd023e0346dae27f0
Full Text :
https://doi.org/10.1016/j.cca.2020.11.019