Related Experiment Video
Updated: Dec 8, 2025
Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
Clinical features predicting mortality risk in older patients with COVID-19
Jing Zhou1,2, Lili Huang3, Jin Chen4
1Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
A new NLAUD score effectively predicts mortality in older COVID-19 patients. This easy-to-use tool utilizes neutrophil-to-lymphocyte ratio, lactate dehydrogenase, albumin, urea nitrogen, and D-dimer for early risk stratification.
Area of Science:
- Gerontology
- Infectious Diseases
- Clinical Medicine
Background:
- Coronavirus disease 2019 (COVID-19) has caused over a million deaths globally, with over 90% affecting individuals aged 60 and older.
- The high mortality rate in elderly COVID-19 patients necessitates a simple clinical tool for predicting mortality risk.
Purpose of the Study:
- To develop and evaluate an easy-to-use clinical tool for predicting mortality risk in older patients diagnosed with COVID-19.
- To identify key clinical and laboratory markers associated with mortality in elderly COVID-19 patients.
Main Methods:
- A retrospective analysis was conducted on 118 elderly COVID-19 patients admitted to Union Dongxihu Hospital between January and February 2020.
- Epidemiological, demographic, clinical, and laboratory data were collected and compared between patients who died and those who were discharged.
- A multivariate logistic regression model was used to identify significant predictors of mortality and develop the NLAUD score.
Main Results:
- No significant differences in major symptoms were observed between non-survivors and survivors.
- Neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase, albumin, urea nitrogen, and D-dimer (NLAUD) were identified as significant predictors of mortality.
- The developed NLAUD score demonstrated high predictive ability (AUROC = 0.955), outperforming the CURB-65 score (AUROC = 0.703) and showing high sensitivity (0.889) and specificity (0.984) upon bootstrap validation.
Conclusions:
- The NLAUD score serves as an effective, easy-to-use clinical tool for the early identification of mortality risk in older COVID-19 patients.
- This predictive tool can aid in stratifying treatment and managing severe cases among elderly individuals with COVID-19.
Background:
Since December 2019, the cumulative number of coronavirus disease 2019 (COVID-19) deaths worldwide has reached 1,013,100 and continues to increase as of writing. Of these deaths, more than 90% are people aged 60 and older. Therefore, there is a need for an easy-to-use clinically predictive tool for predicting mortality risk in older individuals with COVID-19.
Objective:
To explore an easy-to-use clinically predictive tool that may be utilized in predicting mortality risk in older patients with COVID-19.
Methods:
A retrospective analysis of 118 older patients with COVID-19 admitted to the Union Dongxihu Hospital, Huazhong University of Science and Technology, Wuhan, China from 12 January to 26 February 2020. The main results of epidemiological, demographic, clinical and laboratory tests on admission were collected and compared between dying and discharged patients.
Results:
No difference in major symptoms was observed between dying and discharged patients. Among the results of laboratory tests, neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase, albumin, urea nitrogen and D-dimer (NLAUD) show greater differences and have better regression coefficients (β) when using hierarchical comparisons in a multivariate logistic regression model. Predictors of mortality based on better regression coefficients (β) included NLR (OR = 31.2, 95% CI 6.7-144.5, p < .0001), lactate dehydrogenase (OR = 73.4, 95% CI 11.8-456.8, p < .0001), albumin (OR < 0.1, 95% CI <0.1-0.2, p < .0001), urea nitrogen (OR = 12.0, 95% CI 3.0-48.4, p = .0005), and D-dimer (OR = 13.6, 95% CI 3.4-54.9, p = .0003). According to the above indicators, a predictive NLAUD score was calculated on the basis of a multivariate logistic regression model to predict mortality. This model showed a sensitivity of 0.889, specificity of 0.984 and a better predictive ability than CURB-65 (AUROC = 0.955 vs. 0.703, p < .001). Bootstrap validation generated the similar sensitivity and specificity.
Conclusions:
We designed an easy-to-use clinically predictive tool for early identification and stratified treatment of older patients with severe COVID-19.
More Related Videos
05:16Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
06:46Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Related Concept Videos
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:30Pneumonia III: Complications and Assessment
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
01:23Acute Respiratory Failure-IV
01:26Heart Failure III: Clinical Manifestations
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion