Clinical prediction rules for adverse outcomes in patients with SARS
COV-2 infection by the omicron variant
Abstract
Background. Factors related to an adverse evolution in COVID19 infection
are needed for proper decision making. We try to identify factors
related to hospitalization, ICU admission, and mortality related to the
infection. Methods. Retrospective cohort study of patients with
SARS-CoV-2 infection from March 1st 2020 to January 9th 2022. The sample
was randomly divided into two subsamples, for the purposes of derivation
and validation of the prediction rule, until omicron variant appearance
and afterwards, respectively. Data collected for this study included
sociodemographic data, baseline comorbidities and treatments, and other
background data. Multivariable logistic regression models using Lasso
logistic regression were used . Results. In the multivariable models,
older age, male, peripheral vascular disease, heart failure, heart
disease, cerebrovascular, dementia, liver, kidney, diabetes, hemiplegia,
interstitial pulmonary disease, cystic fibrosis, malignant tumors, as
well as diuretics and the chronic systemic use of steroids were common
predictive factors of death. Similar predictors, except liver disease,
plus arterial hypertension, were also related to adverse evolution.
Similar predictors to the previous, including liver disease, plus
dyslipidemia, inflammatory bowel disease, respiratory diseases, and the
basal prescription of NSAIDs, heparin, bronchodilators, or
immunosuppressants were related to hospital admission. All risk scores
developed had AUCs from 0.79 (hospital admission) to 0.94 (death) in the
validation in the omicron sample. Conclusions. We propose three risk
scales for adverse outcomes and hospital admission easy to calculate and
with high predictive capacity, which also work with the current omicron
variant, which can help manage patients in primary, emergency, and
hospital care.