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10.1016/j.jaip.2020.10.043

http://scihub22266oqcxt.onion/10.1016/j.jaip.2020.10.043
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33160092!7640885!33160092
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suck abstract from ncbi


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pmid33160092      J+Allergy+Clin+Immunol+Pract 2021 ; 9 (1): 177-184.e3
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  • Predictive Nomogram for Severe COVID-19 and Identification of Mortality-Related Immune Features #MMPMID33160092
  • Cai L; Zhou X; Wang M; Mei H; Ai L; Mu S; Zhao X; Chen W; Hu Y; Wang H
  • J Allergy Clin Immunol Pract 2021[Jan]; 9 (1): 177-184.e3 PMID33160092show ga
  • BACKGROUND: Patients with severe 2019 novel coronavirus disease (COVID-19) have a high mortality rate. The early identification of severe COVID-19 is of critical concern. In addition, the correlation between the immunological features and clinical outcomes in severe cases needs to be explored. OBJECTIVE: To build a nomogram for identifying patients with severe COVID-19 and explore the immunological features correlating with fatal outcomes. METHODS: We retrospectively enrolled 85 and 41 patients with COVID-19 in primary and validation cohorts, respectively. A predictive nomogram based on risk factors for severe COVID-19 was constructed using the primary cohort and evaluated internally and externally. In addition, in the validation cohort, immunological features in patients with severe COVID-19 were analyzed and correlated with disease outcomes. RESULTS: The risk prediction nomogram incorporating age, C-reactive protein, and D-dimer for early identification of patients with severe COVID-19 showed favorable discrimination in both the primary (area under the curve [AUC] 0.807) and validation cohorts (AUC 0.902) and was well calibrated. Patients who died from COVID-19 showed lower abundance of peripheral CD45RO(+)CD3(+) T cells and natural killer cells, but higher neutrophil counts than that in the patients who recovered (P = .001, P = .009, and P = .009, respectively). Moreover, the abundance of CD45RO(+)CD3(+) T cells, neutrophil-to-lymphocyte ratio, and neutrophil-to-natural killer cell ratio were strong indicators of death in patients with severe COVID-19 (AUC 0.933 for all 3). CONCLUSION: The novel nomogram aided the early identification of severe COVID-19 cases. In addition, the abundance of CD45RO(+)CD3(+) T cells and neutrophil-to-lymphocyte and neutrophil-to-natural killer cell ratios may serve as useful prognostic predictors in severe patients.
  • |*Nomograms[MESH]
  • |Age Factors[MESH]
  • |Aged[MESH]
  • |C-Reactive Protein/immunology[MESH]
  • |COVID-19/*epidemiology/*immunology/mortality[MESH]
  • |Female[MESH]
  • |Flow Cytometry[MESH]
  • |Humans[MESH]
  • |Lymphocytes/immunology[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Neutrophils/immunology[MESH]
  • |Retrospective Studies[MESH]
  • |Risk Assessment[MESH]
  • |Risk Factors[MESH]


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