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

 
Input
 
Age  
Coronary Artery Disease No (0)

Yes (1)
SOFA Score  
Lymphocyte Count  
D-dimer  

 
Results
 
 
Terms  
Mortality Risk  
 
Decimal Precision  

 
     
 
Include literature references: Yes   No
 
Notes
  • In this calculator, mcg is the abbreviation for micrograms.
  • 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 PubMed Logo
  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 PubMed Logo

 

 
Associated Logical Observation Identifiers Names and Codes [LOINC]
 
Parameter LOINC's and Suggested Units
Age 21612-7 : Years old      21612-7 : yr      21612-7 : years      30525-0 : Years old      30525-0 : yr      30525-0 : years      
Lymphocyte Count 731-0 : x10^3/microL      26474-7 : x10^3/microL      
D Dimer 48065-7 : mcg/mL      71427-9 : mcg/mL      91556-1 : mcg/mL      

 
This material contains content from LOINC® (http://loinc.org). The LOINC table, LOINC codes, and LOINC panels and forms file are copyright © 1995-2014, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and available at no cost under the license at http://loinc.org/terms-of-use.

 
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All information contained in and produced by the EBMcalc system is provided for educational purposes only. This information should not be used for the diagnosis or treatment of any health problem or disease. THIS INFORMATION IS NOT INTENDED TO REPLACE CLINICAL JUDGMENT OR GUIDE INDIVIDUAL PATIENT CARE IN ANY MANNER. Click here for full notice and disclaimer.
 
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