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COVID-19 Mortality Risk Estimation (Zhou 3/11/2020)

 

Input
 

Age		mo yr
Coronary Artery Disease	No (0)
	Yes (1)
SOFA Score		# count index logit none number points score
Lymphocyte Count		#/mcL #/microL / nl /mcL /microL /uL 10*3/uL 10*6/uL 10*6/uL 10E+9/L 10^3/microL K/mm3 K/uL Mill/mcl Million/ul Thous/mcL Thousand/uL X10E+09/L X10E+12/L cells/mcL cells/microL m/cmm thou/mcL x10(12)/L x10(3)/mcL x10(3)/microL x10(6)/L x10(6)/mcL x10(6)/microL x10(9)/L x1000/mm3 x10^12/L x10^3/mcL x10^3/microL x10^6/L x10^6/mcL x10^6/microL x10^9/L {cells}/uL
D-dimer		mcg(DDU)/L mcg(DDU)/mL mcg(FEU)/L mcg(FEU)/mL mcg/mL mg(DDU)/L mg(FEU)/L mg/L ng(DDU)/mL ng(FEU)/mL

 
Results
 
Important: Inputs must be complete to perform calculation.

 

Terms		# count index logit none number points score
Mortality Risk		% fraction percent rate ratio
Decimal Precision   0 1 2 3

 

Data action

 
     
 
Include literature references: Yes   No

 

 

Notes

• In this calculator, mcg is the abbreviation for micrograms.
• This calculator represents findings from the literature referenced below. It is important to understand that these findings may not be representative of the experience in your local healthcare system.
• This algorithm is based on early data from the Chinese outbreak of COVID-19. The results cannot be verified to be clinically accurate at your organization.
• The calculator incorporates the linear model coefficients published in the Zhou article supplementary appendix table 3.^[2] The coefficients are noted to be "adjusted for study center."
• In this model, older Age, the presence of Coronary Artery Disease, Higher SOFA Score, and elevated D-dimer are associated with increased mortality. Higher Lymphocyte Count reduces risk in this calculation.
• In this article, the Lymphocyte Count is used with units of x10⁹/L. Lower counts (0.5 to 0.8 x10⁹/L) were associated with mortality. If you choose to enter Lymphocyte Count with an alternative unit-of-measure the calculator automatically adjusts for this.
• SOFA: Sequential Organ Failure Assessment.^[3]

 
Equations used
 

Terms = (Age * 0.096) + Coronary Artery Disease + (SOFAScore * 1.73) + (LymphocyteCount * -1.63) + DdimerFactor - 12.73

MortalityRisk = 100 * e(Terms) / (1 + e(Terms))

 

 

Calculation Details and Variables

• Equation parameters such as Coronary Artery Disease, have two or more discrete values that may be used in the calculation. The numbers in the parentheses, e.g. (0), represent the values that will be used.
• DdimerFactor is assigned values by this ordered logic:
  • If D-dimer >1 mcg/mL, DdimerFactor = 2.67
  • Else if D-dimer >0.5 mcg/mL, DdimerFactor = 0.58
  • Else DdimerFactor = 0.

 

References

1. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 11. pii: S0140-6736(20)30566-3. PubMed ID: 32171076
2. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study [Supplemental Material]. Lancet. https://www.thelancet.com/cms/10.1016/S0140-6736(20)30566-3/attachment/27d0a2d9-639c-41ec-bb37-96b83a72db44/mmc1.pdf accessed 3/18/2020.
3. Vincent JL, de Mendonca A, Cantraine F, et al. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine. Crit Care Med. 1998 Nov;26(11):1793-800. PubMed ID: 9824069

 

Associated Medical Subject Headings [MeSH]
 

80 and over,   Adolescent,   Adult,   Age Factors,   Aged,   Betacoronavirus,   Cardiovascular Diseases,   Clinical Laboratory Techniques,   Cohort Studies,   Comorbidity,   Coronavirus Infections,   Diabetes Complications,   Disease Progression,   Female,   Fibrin Fibrinogen Degradation Products,   Hospital Mortality,   Humans,   Hypertension,   Incidence,   Intensive Care Units,   Male,   Middle Aged,   Mortality,   Multiple Organ Failure,   Organ Dysfunction Scores,   Pandemics,   Patient Care Planning,   Patient Isolation,   Pneumonia,   Prognosis,   Prospective Studies,   Retrospective Studies,   Risk Assessment,   Risk Factors,   Severity of Illness Index,   Time Factors,   Viral,   Young Adult

 

Associated Logical Observation Identifiers Names and Codes [LOINC]
 

Parameter	LOINC's and Suggested Units
Age	21612-7 : yr      21612-7 : yr      21612-7 : years      30525-0 : Years old      30525-0 : yr      30525-0 : years
SOFA Score	96790-1 : score
Lymphocyte Count	731-0 : x10^3/microL      26474-7 : x10^3/microL      732-8 : x10^3/microL
D Dimer	48065-7 : mcg/mL      71427-9 : mcg/mL

 
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