Predication of oxygen requirement in COVID-19 patients using dynamic change of inflammatory markers: CRP, hypertension, age, neutrophil and lymphocyte (CHANeL)

Sci Rep. 2021 Jun 22;11(1):13026. doi: 10.1038/s41598-021-92418-2.

Abstract

The objective of the study was to develop and validate a prediction model that identifies COVID-19 patients at risk of requiring oxygen support based on five parameters: C-reactive protein (CRP), hypertension, age, and neutrophil and lymphocyte counts (CHANeL). This retrospective cohort study included 221 consecutive COVID-19 patients and the patients were randomly assigned randomly to a training set and a test set in a ratio of 1:1. Logistic regression, logistic LASSO regression, Random Forest, Support Vector Machine, and XGBoost analyses were performed based on age, hypertension status, serial CRP, and neutrophil and lymphocyte counts during the first 3 days of hospitalization. The ability of the model to predict oxygen requirement during hospitalization was tested. During hospitalization, 45 (41.8%) patients in the training set (n = 110) and 41 (36.9%) in the test set (n = 111) required supplementary oxygen support. The logistic LASSO regression model exhibited the highest AUC for the test set, with a sensitivity of 0.927 and a specificity of 0.814. An online risk calculator for oxygen requirement using CHANeL predictors was developed. "CHANeL" prediction models based on serial CRP, neutrophil, and lymphocyte counts during the first 3 days of hospitalization, along with age and hypertension status, provide a reliable estimate of the risk of supplement oxygen requirement among patients hospitalized with COVID-19.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Area Under Curve
  • Biomarkers / analysis
  • Biomarkers / metabolism
  • C-Reactive Protein / analysis*
  • COVID-19 / complications
  • COVID-19 / pathology*
  • COVID-19 / virology
  • Female
  • Humans
  • Hypertension / complications*
  • Logistic Models
  • Lymphocytes / cytology*
  • Lymphocytes / metabolism
  • Male
  • Middle Aged
  • Neutrophils / cytology*
  • Neutrophils / metabolism
  • Oxygen Inhalation Therapy*
  • ROC Curve
  • Retrospective Studies
  • SARS-CoV-2 / isolation & purification
  • Severity of Illness Index
  • Support Vector Machine

Substances

  • Biomarkers
  • C-Reactive Protein