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Автор: Akijas | Category: Samdani forex | Октябрь 2, 2012
Our duty as clinicians is to make sure that the available resources are used fairly and appropriately to save lives. The variations in vaccination uptake [ 8 ] provide an opportunity to assess the beneficial effects of different vaccination doses after accounting for patient risk factors. Among the factors known to affect COVID severity are advanced age [ 9 , 10 , 11 , 12 ], type II diabetes [ 10 , 13 , 14 , 15 , 16 , 17 ], kidney disease [ 10 , 17 , 18 , 19 ], chronic obstructive pulmonary disease COPD [ 19 , 20 , 21 , 22 , 23 ], obesity [ 10 , 14 , 15 , 24 , 25 ], hypertension [ 26 , 27 , 28 ], and malignancy [ 29 ].
The predictions are based on patient age, sex, the clinical factors mentioned above, and vaccination status at the time of infection 0, 1, 2, or 3 doses. To keep the models simple and interpretable, and to allow for deployment in any health provider, we used multivariable logistic regression models based on the most essential risk factors. Regression coefficients and odds ratios OR for each factor are provided, together with a formula to obtain risk estimates for any newly infected individual.
These risk estimates allowed us to identify patients at high risk who would benefit from antiviral medications given early in the course of the disease. A web-based calculator is provided, and the approach to run or adapt the models is fully described. The calculator is in Supplementary Materials. Methods 2. Study Subjects and Study Design This is a population study performed on Leumit Health Services LHS , a national healthcare provider in Israel, which provides services to around , members throughout the country.
The number of vaccine doses received were calculated at the index date. Diagnosis and laboratory data were queried as known 15 days before the index date. The presence of comorbidity conditions was assessed by the presence of an active chronic diagnosis at this date.
Chronic diagnoses, coded according to the International Classification of Diseases 9th revision ICD-9 , are regularly added, updated, or ended by the treating physician at each encounter. The validity of chronic diagnoses in the registry has been previously examined and confirmed as high [ 30 , 31 , 32 ]. To keep the models as simple as possible, we deliberately limited the models to the conditions that we identified as having the most significant effect on disease severity: hypertension, chronic obstructive pulmonary disease COPD , and malignancy solid or hematologic.
Individuals who had a pregnancy diagnosis up to days before the PCR test were excluded as hospitalization would often pertain to pregnancy surveillance or delivery and not reflect disease severity. Informed consent was waived because this is a large-scale retrospective study and all data were deidentified.
Statistical Analyses Standard descriptive statistics were used to present the demographic characteristics of individuals included in the study cohort. Play Safe. Min deposit requirement. Free Bets are paid as Bet Credits and are available for use upon settlement of bets to value of qualifying deposit. Min odds, bet and payment method exclusions apply. Returns exclude Bet Credits stake. First bet must be on Sports.
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