
| 10.1039/d0lc00373e
http://scihub22266oqcxt.onion/10.1039/d0lc00373e
 32490853!7360344!32490853
free
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Lab+Chip 2020 ; 20 (12): 2075-2085 Nephropedia Template TP
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Clinical decision support tool and rapid point-of-care platform for determining disease severity in patients with COVID-19 #MMPMID32490853McRae MP; Simmons GW; Christodoulides NJ; Lu Z; Kang SK; Fenyo D; Alcorn T; Dapkins IP; Sharif I; Vurmaz D; Modak SS; Srinivasan K; Warhadpande S; Shrivastav R; McDevitt JTLab Chip 2020[Jun]; 20 (12): 2075-2085 PMID32490853show ga
SARS-CoV-2 is the virus that causes coronavirus disease (COVID-19) which has reached pandemic levels resulting in significant morbidity and mortality affecting every inhabited continent. The large number of patients requiring intensive care threatens to overwhelm healthcare systems globally. Likewise, there is a compelling need for a COVID-19 disease severity test to prioritize care and resources for patients at elevated risk of mortality. Here, an integrated point-of-care COVID-19 Severity Score and clinical decision support system is presented using biomarker measurements of C-reactive protein (CRP), N-terminus pro B type natriuretic peptide (NT-proBNP), myoglobin (MYO), D-dimer, procalcitonin (PCT), creatine kinase-myocardial band (CK-MB), and cardiac troponin I (cTnI). The COVID-19 Severity Score combines multiplex biomarker measurements and risk factors in a statistical learning algorithm to predict mortality. The COVID-19 Severity Score was trained and evaluated using data from 160 hospitalized COVID-19 patients from Wuhan, China. Our analysis finds that COVID-19 Severity Scores were significantly higher for the group that died versus the group that was discharged with median (interquartile range) scores of 59 (40-83) and 9 (6-17), respectively, and area under the curve of 0.94 (95% CI 0.89-0.99). Although this analysis represents patients with cardiac comorbidities (hypertension), the inclusion of biomarkers from other pathophysiologies implicated in COVID-19 (e.g., D-dimer for thrombotic events, CRP for infection or inflammation, and PCT for bacterial co-infection and sepsis) may improve future predictions for a more general population. These promising initial models pave the way for a point-of-care COVID-19 Severity Score system to impact patient care after further validation with externally collected clinical data. Clinical decision support tools for COVID-19 have strong potential to empower healthcare providers to save lives by prioritizing critical care in patients at high risk for adverse outcomes.|*Point-of-Care Systems[MESH]|Algorithms[MESH]|Biomarkers[MESH]|COVID-19[MESH]|Comorbidity[MESH]|Coronavirus Infections/*diagnosis/physiopathology[MESH]|Critical Care[MESH]|Decision Support Systems, Clinical/*organization & administration[MESH]|Humans[MESH]|Image Processing, Computer-Assisted[MESH]|Immunoassay/methods[MESH]|Machine Learning[MESH]|Pandemics[MESH]|Pneumonia, Viral/*diagnosis/physiopathology[MESH]|Predictive Value of Tests[MESH]|Risk Factors[MESH]|Severity of Illness Index[MESH]|Software[MESH]
  
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