Predictive Score of Risk Associated with Progression of Patients with COVID-19 Pneumonia in Wuhan, China: the ALA Score

Wang, Menghan; Yu, Dongping; Shang, Yu; Zhang, Xiaona; Yang, Yi; Zhao, Shuai; Su, Dongju; Liu, Lei; Wang, Qin; Ren, Juan; Li, Yupeng; Chen, Hong

Background The Coronavirus Disease 2019 (COVID-19) had become a Public Health Emergency of International Concern with more than 90 million confirmed cases worldwide. Therefore, this study aims to establish a predictive score model of progression to severe type in patients with COVID-19. Methods This is a retrospective cohort study of 151 patients with COVID-19 diagnosed by nucleic acid test or specific serum antibodies from February 13, 2020, to March 14, 2020, hospitalized in a COVID-19-designed hospital in Wuhan, China. Results Of the 151 patients with average age of 63 years, 64 patients were male (42.4%), and 29 patients (19.2%) were classified as severe group. Multivariate analysis showed that age > 65 years (odds ratio [OR] = 9.72, 95%CI: 2.92–32.31, P < 0.001), lymphocyte count ≤ 1.1 × 10(9)/L (OR = 3.42, 95%CI: 1.24–9.41, P = 0.017) and AST > 35 U/L (OR = 3.19, 95%CI: 1.11–9.19, P = 0.032) were independent risk factors for the disease severity. The area under curve (AUC) of receiver operating characteristic curve of the probabilities of the composite continuous variable (age + lymphocyte + AST) is 0.796. Finally, a predictive score model called ALA was established, and its AUC was 0.83 (95%CI: 0.75–0.92). Using a cutoff value of 9.5 points, the positive and negative predictive values were 54.1% (38–70.1%) and 92.1% (87.2–97.1%), respectively. Conclusion The ALA score model can quickly identify severe patients with COVID-19, so as to help clinicians to better choose accurate management strategy.