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Development and Validation of an Early Scoring System for Prediction of Disease Severity in COVID-19 Using Complete Blood Count Parameters

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submitted on 2023-08-27, 11:57 and posted on 2023-09-25, 07:35 authored by Tawsifur Rahman, Amith Khandakar, Md Enamul Hoque, Nabil Ibtehaz, Saad Bin Kashem, Reehum Masud, Lutfunnahar Shampa, Mohammad Mehedi Hasan, Mohammad Tariqul Islam, Somaya Al-Maadeed, Susu M. Zughaier, Saif Badran, Suhail A. R. Doi, Muhammad E. H. Chowdhury

The coronavirus disease 2019 (COVID-19) after outbreaking in Wuhan increasingly spread throughout the world. Fast, reliable, and easily accessible clinical assessment of the severity of the disease can help in allocating and prioritizing resources to reduce mortality. The objective of the study was to develop and validate an early scoring tool to stratify the risk of death using readily available complete blood count (CBC) biomarkers. A retrospective study was conducted on twenty-three CBC blood biomarkers for predicting disease mortality for 375 COVID-19 patients admitted to Tongji Hospital, China from January 10 to February 18, 2020. Machine learning based key biomarkers among the CBC parameters as the mortality predictors were identified. A multivariate logistic regression-based nomogram and a scoring system was developed to categorize the patients in three risk groups (low, moderate, and high) for predicting the mortality risk among COVID-19 patients. Lymphocyte count, neutrophils count, age, white blood cell count, monocytes (%), platelet count, red blood cell distribution width parameters collected at hospital admission were selected as important biomarkers for death prediction using random forest feature selection technique. A CBC score was devised for calculating the death probability of the patients and was used to categorize the patients into three sub-risk groups: low (<=5%), moderate (>5% and <=50%), and high (>50%), respectively. The area under the curve (AUC) of the model for the development and internal validation cohort were 0.961 and 0.88, respectively. The proposed model was further validated with an external cohort of 103 patients of Dhaka Medical College, Bangladesh, which exhibits in an AUC of 0.963. The proposed CBC parameter-based prognostic model and the associated web-application, can help the medical doctors to improve the management by early prediction of mortality risk of the COVID-19 patients in the low-resource countries.

Other Information

Published in: IEEE Access
License: https://creativecommons.org/licenses/by/4.0/
See article on publisher's website: https://dx.doi.org/10.1109/access.2021.3105321

Funding

Open Access funding provided by the Qatar National Library.

History

Language

  • English

Publisher

IEEE

Publication Year

  • 2021

License statement

This Item is licensed under the Creative Commons Attribution 4.0 International License.

Institution affiliated with

  • Qatar University
  • College of Engineering - QU
  • Qatar Armed Forces
  • Faculty of Robotics and Advanced Computing - QAF
  • Academic Bridge Program
  • Qatar University Health - QU
  • College of Medicine - QU HEALTH
  • Hamad Medical Corporation