SARS-CoV-2 infection and cardiovascular or pulmonary complications in ambulatory care: A risk assessment based on routine data

<h4>Background</h4> Risk factors of severe COVID-19 have mainly been investigated in the hospital setting. We investigated pre-defined risk factors for testing positive for SARS-CoV-2 infection and cardiovascular or pulmonary complications in the outpatient setting. <h4>Methods<...

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Autores principales:	Siranush Karapetyan, Antonius Schneider, Klaus Linde, Ewan Donnachie, Alexander Hapfelmeier
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/74210886932b441f94306286f9dd5ade
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spelling	oai:doaj.org-article:74210886932b441f94306286f9dd5ade2021-11-04T06:07:15ZSARS-CoV-2 infection and cardiovascular or pulmonary complications in ambulatory care: A risk assessment based on routine data1932-6203https://doaj.org/article/74210886932b441f94306286f9dd5ade2021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8530335/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4> Risk factors of severe COVID-19 have mainly been investigated in the hospital setting. We investigated pre-defined risk factors for testing positive for SARS-CoV-2 infection and cardiovascular or pulmonary complications in the outpatient setting. <h4>Methods</h4> The present cohort study makes use of ambulatory claims data of statutory health insurance physicians in Bavaria, Germany, with polymerase chain reaction (PCR) test confirmed or excluded SARS-CoV-2 infection in first three quarters of 2020. Statistical modelling and machine learning were used for effect estimation and for hypothesis testing of risk factors, and for prognostic modelling of cardiovascular or pulmonary complications. <h4>Results</h4> A cohort of 99 811 participants with PCR test was identified. In a fully adjusted multivariable regression model, dementia (odds ratio (OR) = 1.36), type 2 diabetes (OR = 1.14) and obesity (OR = 1.08) were identified as significantly associated with a positive PCR test result. Significant risk factors for cardiovascular or pulmonary complications were coronary heart disease (CHD) (OR = 2.58), hypertension (OR = 1.65), tobacco consumption (OR = 1.56), chronic obstructive pulmonary disease (COPD) (OR = 1.53), previous pneumonia (OR = 1.53), chronic kidney disease (CKD) (OR = 1.25) and type 2 diabetes (OR = 1.23). Three simple decision rules derived from prognostic modelling based on age, hypertension, CKD, COPD and CHD were able to identify high risk patients with a sensitivity of 74.8% and a specificity of 80.0%. <h4>Conclusions</h4> The decision rules achieved a high prognostic accuracy non-inferior to complex machine learning methods. They might help to identify patients at risk, who should receive special attention and intensified protection in ambulatory care.Siranush KarapetyanAntonius SchneiderKlaus LindeEwan DonnachieAlexander HapfelmeierPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Siranush Karapetyan Antonius Schneider Klaus Linde Ewan Donnachie Alexander Hapfelmeier SARS-CoV-2 infection and cardiovascular or pulmonary complications in ambulatory care: A risk assessment based on routine data
description	<h4>Background</h4> Risk factors of severe COVID-19 have mainly been investigated in the hospital setting. We investigated pre-defined risk factors for testing positive for SARS-CoV-2 infection and cardiovascular or pulmonary complications in the outpatient setting. <h4>Methods</h4> The present cohort study makes use of ambulatory claims data of statutory health insurance physicians in Bavaria, Germany, with polymerase chain reaction (PCR) test confirmed or excluded SARS-CoV-2 infection in first three quarters of 2020. Statistical modelling and machine learning were used for effect estimation and for hypothesis testing of risk factors, and for prognostic modelling of cardiovascular or pulmonary complications. <h4>Results</h4> A cohort of 99 811 participants with PCR test was identified. In a fully adjusted multivariable regression model, dementia (odds ratio (OR) = 1.36), type 2 diabetes (OR = 1.14) and obesity (OR = 1.08) were identified as significantly associated with a positive PCR test result. Significant risk factors for cardiovascular or pulmonary complications were coronary heart disease (CHD) (OR = 2.58), hypertension (OR = 1.65), tobacco consumption (OR = 1.56), chronic obstructive pulmonary disease (COPD) (OR = 1.53), previous pneumonia (OR = 1.53), chronic kidney disease (CKD) (OR = 1.25) and type 2 diabetes (OR = 1.23). Three simple decision rules derived from prognostic modelling based on age, hypertension, CKD, COPD and CHD were able to identify high risk patients with a sensitivity of 74.8% and a specificity of 80.0%. <h4>Conclusions</h4> The decision rules achieved a high prognostic accuracy non-inferior to complex machine learning methods. They might help to identify patients at risk, who should receive special attention and intensified protection in ambulatory care.
format	article
author	Siranush Karapetyan Antonius Schneider Klaus Linde Ewan Donnachie Alexander Hapfelmeier
author_facet	Siranush Karapetyan Antonius Schneider Klaus Linde Ewan Donnachie Alexander Hapfelmeier
author_sort	Siranush Karapetyan
title	SARS-CoV-2 infection and cardiovascular or pulmonary complications in ambulatory care: A risk assessment based on routine data
title_short	SARS-CoV-2 infection and cardiovascular or pulmonary complications in ambulatory care: A risk assessment based on routine data
title_full	SARS-CoV-2 infection and cardiovascular or pulmonary complications in ambulatory care: A risk assessment based on routine data
title_fullStr	SARS-CoV-2 infection and cardiovascular or pulmonary complications in ambulatory care: A risk assessment based on routine data
title_full_unstemmed	SARS-CoV-2 infection and cardiovascular or pulmonary complications in ambulatory care: A risk assessment based on routine data
title_sort	sars-cov-2 infection and cardiovascular or pulmonary complications in ambulatory care: a risk assessment based on routine data
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/74210886932b441f94306286f9dd5ade
work_keys_str_mv	AT siranushkarapetyan sarscov2infectionandcardiovascularorpulmonarycomplicationsinambulatorycareariskassessmentbasedonroutinedata AT antoniusschneider sarscov2infectionandcardiovascularorpulmonarycomplicationsinambulatorycareariskassessmentbasedonroutinedata AT klauslinde sarscov2infectionandcardiovascularorpulmonarycomplicationsinambulatorycareariskassessmentbasedonroutinedata AT ewandonnachie sarscov2infectionandcardiovascularorpulmonarycomplicationsinambulatorycareariskassessmentbasedonroutinedata AT alexanderhapfelmeier sarscov2infectionandcardiovascularorpulmonarycomplicationsinambulatorycareariskassessmentbasedonroutinedata
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SARS-CoV-2 infection and cardiovascular or pulmonary complications in ambulatory care: A risk assessment based on routine data

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