Development of a Prediction Model for COVID‐19 Acute Respiratory Distress Syndrome in Patients With Rheumatic Diseases: Results From the Global Rheumatology Alliance Registry

Objective Some patients with rheumatic diseases might be at higher risk for coronavirus disease 2019 (COVID‐19) acute respiratory distress syndrome (ARDS). We aimed to develop a prediction model for COVID‐19 ARDS in this population and to create a simple risk score calculator for use in clinical set...

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Main Authors: Zara Izadi, Milena A. Gianfrancesco, Alfredo Aguirre, Anja Strangfeld, Elsa F. Mateus, Kimme L. Hyrich, Laure Gossec, Loreto Carmona, Saskia Lawson‐Tovey, Lianne Kearsley‐Fleet, Martin Schaefer, Andrea M. Seet, Gabriela Schmajuk, Lindsay Jacobsohn, Patricia Katz, Stephanie Rush, Samar Al‐Emadi, Jeffrey A. Sparks, Tiffany Y‐T Hsu, Naomi J. Patel, Leanna Wise, Emily Gilbert, Alí Duarte‐García, Maria O. Valenzuela‐Almada, Manuel F. Ugarte‐Gil, Sandra Lúcia Euzébio Ribeiro, Adriana deOliveira Marinho, Lilian David deAzevedo Valadares, Daniela Di Giuseppe, Rebecca Hasseli, Jutta G. Richter, Alexander Pfeil, Tim Schmeiser, Carolina A. Isnardi, Alvaro A. Reyes Torres, Gelsomina Alle, Verónica Saurit, Anna Zanetti, Greta Carrara, Julien Labreuche, Thomas Barnetche, Muriel Herasse, Samira Plassart, Maria José Santos, Ana Maria Rodrigues, Philip C. Robinson, Pedro M. Machado, Emily Sirotich, Jean W. Liew, Jonathan S. Hausmann, Paul Sufka, Rebecca Grainger, Suleman Bhana, Wendy Costello, Zachary S. Wallace, Jinoos Yazdany, Global Rheumatology Alliance Registry
Format: Article
Language:English
Published: Wiley 2022-10-01
Series:ACR Open Rheumatology
Online Access:https://doi.org/10.1002/acr2.11481
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author Zara Izadi
Milena A. Gianfrancesco
Alfredo Aguirre
Anja Strangfeld
Elsa F. Mateus
Kimme L. Hyrich
Laure Gossec
Loreto Carmona
Saskia Lawson‐Tovey
Lianne Kearsley‐Fleet
Martin Schaefer
Andrea M. Seet
Gabriela Schmajuk
Lindsay Jacobsohn
Patricia Katz
Stephanie Rush
Samar Al‐Emadi
Jeffrey A. Sparks
Tiffany Y‐T Hsu
Naomi J. Patel
Leanna Wise
Emily Gilbert
Alí Duarte‐García
Maria O. Valenzuela‐Almada
Manuel F. Ugarte‐Gil
Sandra Lúcia Euzébio Ribeiro
Adriana deOliveira Marinho
Lilian David deAzevedo Valadares
Daniela Di Giuseppe
Rebecca Hasseli
Jutta G. Richter
Alexander Pfeil
Tim Schmeiser
Carolina A. Isnardi
Alvaro A. Reyes Torres
Gelsomina Alle
Verónica Saurit
Anna Zanetti
Greta Carrara
Julien Labreuche
Thomas Barnetche
Muriel Herasse
Samira Plassart
Maria José Santos
Ana Maria Rodrigues
Philip C. Robinson
Pedro M. Machado
Emily Sirotich
Jean W. Liew
Jonathan S. Hausmann
Paul Sufka
Rebecca Grainger
Suleman Bhana
Wendy Costello
Zachary S. Wallace
Jinoos Yazdany
Global Rheumatology Alliance Registry
author_facet Zara Izadi
Milena A. Gianfrancesco
Alfredo Aguirre
Anja Strangfeld
Elsa F. Mateus
Kimme L. Hyrich
Laure Gossec
Loreto Carmona
Saskia Lawson‐Tovey
Lianne Kearsley‐Fleet
Martin Schaefer
Andrea M. Seet
Gabriela Schmajuk
Lindsay Jacobsohn
Patricia Katz
Stephanie Rush
Samar Al‐Emadi
Jeffrey A. Sparks
Tiffany Y‐T Hsu
Naomi J. Patel
Leanna Wise
Emily Gilbert
Alí Duarte‐García
Maria O. Valenzuela‐Almada
Manuel F. Ugarte‐Gil
Sandra Lúcia Euzébio Ribeiro
Adriana deOliveira Marinho
Lilian David deAzevedo Valadares
Daniela Di Giuseppe
Rebecca Hasseli
Jutta G. Richter
Alexander Pfeil
Tim Schmeiser
Carolina A. Isnardi
Alvaro A. Reyes Torres
Gelsomina Alle
Verónica Saurit
Anna Zanetti
Greta Carrara
Julien Labreuche
Thomas Barnetche
Muriel Herasse
Samira Plassart
Maria José Santos
Ana Maria Rodrigues
Philip C. Robinson
Pedro M. Machado
Emily Sirotich
Jean W. Liew
Jonathan S. Hausmann
Paul Sufka
Rebecca Grainger
Suleman Bhana
Wendy Costello
Zachary S. Wallace
Jinoos Yazdany
Global Rheumatology Alliance Registry
author_sort Zara Izadi
collection DOAJ
description Objective Some patients with rheumatic diseases might be at higher risk for coronavirus disease 2019 (COVID‐19) acute respiratory distress syndrome (ARDS). We aimed to develop a prediction model for COVID‐19 ARDS in this population and to create a simple risk score calculator for use in clinical settings. Methods Data were derived from the COVID‐19 Global Rheumatology Alliance Registry from March 24, 2020, to May 12, 2021. Seven machine learning classifiers were trained on ARDS outcomes using 83 variables obtained at COVID‐19 diagnosis. Predictive performance was assessed in a US test set and was validated in patients from four countries with independent registries using area under the curve (AUC), accuracy, sensitivity, and specificity. A simple risk score calculator was developed using a regression model incorporating the most influential predictors from the best performing classifier. Results The study included 8633 patients from 74 countries, of whom 523 (6%) had ARDS. Gradient boosting had the highest mean AUC (0.78; 95% confidence interval [CI]: 0.67‐0.88) and was considered the top performing classifier. Ten predictors were identified as key risk factors and were included in a regression model. The regression model that predicted ARDS with 71% (95% CI: 61%‐83%) sensitivity in the test set, and with sensitivities ranging from 61% to 80% in countries with independent registries, was used to develop the risk score calculator. Conclusion We were able to predict ARDS with good sensitivity using information readily available at COVID‐19 diagnosis. The proposed risk score calculator has the potential to guide risk stratification for treatments, such as monoclonal antibodies, that have potential to reduce COVID‐19 disease progression.
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spelling doaj.art-09d83890d8f2409abe26d8307e2633b32022-12-22T04:30:12ZengWileyACR Open Rheumatology2578-57452022-10-0141087288210.1002/acr2.11481Development of a Prediction Model for COVID‐19 Acute Respiratory Distress Syndrome in Patients With Rheumatic Diseases: Results From the Global Rheumatology Alliance RegistryZara Izadi0Milena A. Gianfrancesco1Alfredo Aguirre2Anja Strangfeld3Elsa F. Mateus4Kimme L. Hyrich5Laure Gossec6Loreto Carmona7Saskia Lawson‐Tovey8Lianne Kearsley‐Fleet9Martin Schaefer10Andrea M. Seet11Gabriela Schmajuk12Lindsay Jacobsohn13Patricia Katz14Stephanie Rush15Samar Al‐Emadi16Jeffrey A. Sparks17Tiffany Y‐T Hsu18Naomi J. Patel19Leanna Wise20Emily Gilbert21Alí Duarte‐García22Maria O. Valenzuela‐Almada23Manuel F. Ugarte‐Gil24Sandra Lúcia Euzébio Ribeiro25Adriana deOliveira Marinho26Lilian David deAzevedo Valadares27Daniela Di Giuseppe28Rebecca Hasseli29Jutta G. Richter30Alexander Pfeil31Tim Schmeiser32Carolina A. Isnardi33Alvaro A. Reyes Torres34Gelsomina Alle35Verónica Saurit36Anna Zanetti37Greta Carrara38Julien Labreuche39Thomas Barnetche40Muriel Herasse41Samira Plassart42Maria José Santos43Ana Maria Rodrigues44Philip C. Robinson45Pedro M. Machado46Emily Sirotich47Jean W. Liew48Jonathan S. Hausmann49Paul Sufka50Rebecca Grainger51Suleman Bhana52Wendy Costello53Zachary S. Wallace54Jinoos Yazdany55Global Rheumatology Alliance RegistryUniversity of California San FranciscoUniversity of California San FranciscoUniversity of California San FranciscoDeutsches Rheuma‐Forschungszentrum Berlin Berlin GermanyPortuguese League Against Rheumatic Diseases Lisbon PortugalThe University of Manchester and National Institute for Health Research Manchester Biomedical Research Centre, Manchester University and NHS Foundation Trust Manchester UKINSERM, Sorbonne Universite and Hopital Universitaire Pitie Salpetriere, AP‐HP Paris FranceInstituto de Salud Musculoesquelética Madrid SpainThe University of Manchester and National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust and Manchester Academic Health Science Centre Manchester UKThe University of Manchester and Manchester Academic Health Science Centre Manchester UKGerman Rheumatism Research Center Berlin GermanyUniversity of California San FranciscoUniversity of California San Francisco and San Francisco Department of Veterans Affairs Medical CenterUniversity of California San FranciscoUniversity of California San FranciscoUniversity of California San FranciscoHamad Medical Corporation Doha QatarBrigham and Women's Hospital and Harvard Medical School Boston MassachusettsBrigham and Women's Hospital and Harvard Medical School Boston MassachusettsMassachusetts General Hospital and Harvard Medical School BostonUniversity of Southern California Los AngelesMayo Clinic Jacksonville FloridaMayo Clinic Rochester MinnesotaMayo Clinic Rochester MinnesotaUniversidad Científica del Sur and Hospital Nacional Guillermo Almenara Irigoyen EsSalud, Lima PeruUniversidade Federal do Amazonas Manaus BrazilFundação Hospitalar do Acre Rio Branco BrazilUniversidade Federal de Pernambuco Recife BrazilKarolinska Institutet Stockholm SwedenJustus‐Liebig University Giessen, Campus Kerckhoff Giessen GermanyHeinrich‐Heine‐University Düsseldorf Düsseldorf GermanyJena University Hospital and Friedrich Schiller University Jena Jena GermanyRheumatology im Veedel (Private Practice) Cologne GermanyArgentine Society of Rheumatology Buenos Aires ArgentinaHospital Italiano de Buenos Aires Buenos Aires ArgentinaHospital Italiano de Buenos Aires Buenos Aires ArgentinaHospital Privado Universitario de Córdoba Córdoba ArgentinaItalian Society for Rheumatology and University of Milano‐Bicocca Milan ItalyItalian Society for Rheumatology and University of Milano‐Bicocca Milan ItalyCentre Hospitalier Universitaire de Lille Lille FranceFHU ACRONIM, Centre for Autoimmune Systemic Rare Diseases, Bordeaux University Hospital Bordeaux FranceFilière des Maladies Autoimmunes et Autoinflammatoires Rares, Hôpital Huriez, Centre Hospitalier Universitaire de Lille Lille FranceFilière des Maladies Autoimmunes et Autoinflammatoires Rares, Hôpital Huriez, Centre Hospitalier Universitaire de Lille Lille FranceHospital Garcia de Orta, Almada, Portugal, and Instituto de Medicina Molecular Faculdade Medicina and Rheumatic Diseases Portuguese Register Lisbon PortugalRheumatic Diseases Portuguese Register, Sociedade Portuguesa de Reumatologia, Nova Medical School, and Hospital dos Lusiadas Lisbon PortugalThe University of Queensland, Brisbane, Queensland, Australia, and Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service Herston Queensland AustraliaUniversity College London, University College London Hospitals NHS Foundation Trust and Northwick Park Hospital, London North West University Healthcare NHS Trust London UKMcMaster University, Hamilton, Ontario, Canada, and Canadian Arthritis Patient Alliance Toronto Ontario CanadaBoston University School of Medicine Boston MassachusettsBeth Israel Deaconess Medical Center, Harvard Medical School and Boston Children's Hospital Boston MassachusettsHealthPartners St. Paul MinnesotaUniversity of Otago Wellington Wellington New ZealandPfizer Inc. New York New YorkIrish Children's Arthritis Network Tipperary IrelandMassachusetts General Hospital and Harvard Medical School BostonUniversity of California San FranciscoObjective Some patients with rheumatic diseases might be at higher risk for coronavirus disease 2019 (COVID‐19) acute respiratory distress syndrome (ARDS). We aimed to develop a prediction model for COVID‐19 ARDS in this population and to create a simple risk score calculator for use in clinical settings. Methods Data were derived from the COVID‐19 Global Rheumatology Alliance Registry from March 24, 2020, to May 12, 2021. Seven machine learning classifiers were trained on ARDS outcomes using 83 variables obtained at COVID‐19 diagnosis. Predictive performance was assessed in a US test set and was validated in patients from four countries with independent registries using area under the curve (AUC), accuracy, sensitivity, and specificity. A simple risk score calculator was developed using a regression model incorporating the most influential predictors from the best performing classifier. Results The study included 8633 patients from 74 countries, of whom 523 (6%) had ARDS. Gradient boosting had the highest mean AUC (0.78; 95% confidence interval [CI]: 0.67‐0.88) and was considered the top performing classifier. Ten predictors were identified as key risk factors and were included in a regression model. The regression model that predicted ARDS with 71% (95% CI: 61%‐83%) sensitivity in the test set, and with sensitivities ranging from 61% to 80% in countries with independent registries, was used to develop the risk score calculator. Conclusion We were able to predict ARDS with good sensitivity using information readily available at COVID‐19 diagnosis. The proposed risk score calculator has the potential to guide risk stratification for treatments, such as monoclonal antibodies, that have potential to reduce COVID‐19 disease progression.https://doi.org/10.1002/acr2.11481
spellingShingle Zara Izadi
Milena A. Gianfrancesco
Alfredo Aguirre
Anja Strangfeld
Elsa F. Mateus
Kimme L. Hyrich
Laure Gossec
Loreto Carmona
Saskia Lawson‐Tovey
Lianne Kearsley‐Fleet
Martin Schaefer
Andrea M. Seet
Gabriela Schmajuk
Lindsay Jacobsohn
Patricia Katz
Stephanie Rush
Samar Al‐Emadi
Jeffrey A. Sparks
Tiffany Y‐T Hsu
Naomi J. Patel
Leanna Wise
Emily Gilbert
Alí Duarte‐García
Maria O. Valenzuela‐Almada
Manuel F. Ugarte‐Gil
Sandra Lúcia Euzébio Ribeiro
Adriana deOliveira Marinho
Lilian David deAzevedo Valadares
Daniela Di Giuseppe
Rebecca Hasseli
Jutta G. Richter
Alexander Pfeil
Tim Schmeiser
Carolina A. Isnardi
Alvaro A. Reyes Torres
Gelsomina Alle
Verónica Saurit
Anna Zanetti
Greta Carrara
Julien Labreuche
Thomas Barnetche
Muriel Herasse
Samira Plassart
Maria José Santos
Ana Maria Rodrigues
Philip C. Robinson
Pedro M. Machado
Emily Sirotich
Jean W. Liew
Jonathan S. Hausmann
Paul Sufka
Rebecca Grainger
Suleman Bhana
Wendy Costello
Zachary S. Wallace
Jinoos Yazdany
Global Rheumatology Alliance Registry
Development of a Prediction Model for COVID‐19 Acute Respiratory Distress Syndrome in Patients With Rheumatic Diseases: Results From the Global Rheumatology Alliance Registry
ACR Open Rheumatology
title Development of a Prediction Model for COVID‐19 Acute Respiratory Distress Syndrome in Patients With Rheumatic Diseases: Results From the Global Rheumatology Alliance Registry
title_full Development of a Prediction Model for COVID‐19 Acute Respiratory Distress Syndrome in Patients With Rheumatic Diseases: Results From the Global Rheumatology Alliance Registry
title_fullStr Development of a Prediction Model for COVID‐19 Acute Respiratory Distress Syndrome in Patients With Rheumatic Diseases: Results From the Global Rheumatology Alliance Registry
title_full_unstemmed Development of a Prediction Model for COVID‐19 Acute Respiratory Distress Syndrome in Patients With Rheumatic Diseases: Results From the Global Rheumatology Alliance Registry
title_short Development of a Prediction Model for COVID‐19 Acute Respiratory Distress Syndrome in Patients With Rheumatic Diseases: Results From the Global Rheumatology Alliance Registry
title_sort development of a prediction model for covid 19 acute respiratory distress syndrome in patients with rheumatic diseases results from the global rheumatology alliance registry
url https://doi.org/10.1002/acr2.11481
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