cliot (version 1.0.0)

covid_gram_score: COVID-GRAM Critical Illness Risk Score

Description

Calculates the COVID-GRAM score to predict the risk of developing critical illness in patients hospitalized with COVID-19. Critical illness is defined as admission to the intensive care unit, invasive mechanical ventilation, or death. The model was developed by Liang et al. using data from 575 hospitals in China.

Usage

covid_gram_score(age, x_ray_abnormality, hemoptysis, dyspnea, unconsciousness,
                 number_of_comorbidities, cancer_history, nlr, ldh,
                 direct_bilirubin, bilirubin_units = "umol/L")

Value

A list containing:

Critical_Illness_Probability

The estimated percentage probability of critical illness.

Risk_Category

Risk stratification (Low < 1.7%, Medium 1.7-40.4%, High > 40.4%).

Arguments

age

Numeric. Patient age in years.

x_ray_abnormality

Numeric (0 or 1). Presence of radiographic abnormalities on Chest X-ray/CT. (1 = Yes).

hemoptysis

Numeric (0 or 1). Presence of hemoptysis. (1 = Yes).

dyspnea

Numeric (0 or 1). Presence of dyspnea. (1 = Yes).

unconsciousness

Numeric (0 or 1). Presence of unconsciousness or altered mental status. (1 = Yes).

number_of_comorbidities

Numeric. Count of comorbidities (e.g., COPD, hypertension, diabetes, coronary heart disease, CKD, etc.). (0, 1, or >=2).

cancer_history

Numeric (0 or 1). History of cancer. (1 = Yes).

nlr

Numeric. Neutrophil-to-lymphocyte ratio.

ldh

Numeric. Lactate dehydrogenase level (U/L).

direct_bilirubin

Numeric. Direct bilirubin level.

bilirubin_units

String. Units for direct bilirubin. "umol/L" (default) or "mg/dL".

References

Liang W, Liang H, Ou L, et al. Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19. JAMA Intern Med. 2020;180(8):1081-1089. doi:10.1001/jamainternmed.2020.2033

Examples

# Example 1: High Risk
# 70yo, Abnormal CXR, Dyspnea, 2 Comorbs, Cancer, NLR 10, LDH 400, D-Bili 6 umol/L
covid_gram_score(70, 1, 0, 1, 0, 2, 1, 10, 400, 6, "umol/L")

# Example 2: Low Risk
# 30yo, Normal CXR, No symptoms, 0 Comorbs, Normal Labs
covid_gram_score(30, 0, 0, 0, 0, 0, 0, 2, 150, 3, "umol/L")