Development and validation of the patient history COVID-19 (PH-Covid19) scoring system: a multivariable prediction model of death in Mexican patients with COVID-19

• DOI: 10.1017/s0950268820002903
• Publication Date: 2020-11-26T03:59:53Z
• Authors: J. Mancilla-Galindo; J. M. Vera-Zertuche; A. R. Navarro-Cruz; O. Segura-Badilla; G. Reyes-Velázquez; F. J. Tepepa-López; P. Aguilar-Alonso; J. de J. Vidal-Mayo; A. Kammar-García
• Keywords: Original Paper; Epidemiology; SARS-CoV-2; COVID-19; Comorbidity; Models, Theoretical; Risk Assessment; 3. Good health; 03 medical and health sciences; Infectious Diseases; 0302 clinical medicine; Risk Factors; COVID-19 Nucleic Acid Testing; Humans; Mexico; Pandemics; Forecasting; Proportional Hazards Models; Retrospective Studies

Abstract Most of the existing prediction models for COVID-19 lack validation, are inadequately reported or are at high risk of bias, a reason which has led to discourage their use. Few existing models have the potential to be extensively used by healthcare providers in low-resource settings since many require laboratory and imaging predictors. Therefore, we sought to develop and validate a multivariable prediction model of death in Mexican patients with COVID-19, by using demographic and patient history predictors. We conducted a national retrospective cohort study in two different sets of patients from the Mexican COVID-19 Epidemiologic Surveillance Study. Patients with a positive reverse transcription-polymerase chain reaction for SARS-CoV-2 and complete unduplicated data were eligible. In total, 83 779 patients were included to develop the scoring system through a multivariable Cox regression model; 100 000, to validate the model. Eight predictors (age, sex, diabetes, chronic obstructive pulmonary disease, immunosuppression, hypertension, obesity and chronic kidney disease) were included in the scoring system called PH-Covid19 (range of values: −2 to 25 points). The predictive model has a discrimination of death of 0.8 (95% confidence interval (CI) 0.796–0.804). The PH-Covid19 scoring system was developed and validated in Mexican patients to aid clinicians to stratify patients with COVID-19 at risk of fatal outcomes, allowing for better and efficient use of resources.