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Non-specific blood tests as proxies for COVID-19 hospitalisation: are there plausible associations after excluding noisy predictors?

Authors
  • Ishikawa, G1
  • Argenti, G2
  • Fadel, C B3
  • 1 Professor and researcher, Universidade Tecnologica Federal do Parana (UTFPR), Ponta Grossa, Brazil. , (Brazil)
  • 2 Researcher, Postgraduate Programme in Health Sciences, Universidade Estadual de Ponta Grossa (UEPG), Ponta Grossa, Brazil. , (Brazil)
  • 3 Professor and researcher, Universidade Estadual de Ponta Grossa (UEPG), Ponta Grossa, Brazil. , (Brazil)
Type
Published Article
Journal
Epidemiology and Infection
Publisher
Cambridge University Press
Publication Date
Jan 11, 2021
Volume
149
Identifiers
DOI: 10.1017/S0950268821000078
PMID: 33427157
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

This study applied causal criteria in directed acyclic graphs for handling covariates in associations for prognosis of severe coronavirus disease 2019 (COVID-19) cases. To identify non-specific blood tests and risk factors as predictors of hospitalisation due to COVID-19, one has to exclude noisy predictors by comparing the concordance statistics (area under the curve - AUC) for positive and negative cases of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Predictors with significant AUC at negative stratum should be either controlled for their confounders or eliminated (when confounders are unavailable). Models were classified according to the difference of AUC between strata. The framework was applied to an open database with 5644 patients from Hospital Israelita Albert Einstein in Brazil with SARS-CoV-2 reverse transcription - polymerase chain reaction (RT-PCR) exam. C-reactive protein (CRP) was a noisy predictor: hospitalisation could have happened due to causes other than COVID-19 even when SARS-CoV-2 RT-PCR is positive and CRP is reactive, as most cases are asymptomatic to mild. Candidates of characteristic response from moderate-to-severe inflammation of COVID-19 were: combinations of eosinophils, monocytes and neutrophils, with age as risk factor; and creatinine, as risk factor, sharpens the odds ratio of the model with monocytes, neutrophils and age.

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