Identification of patients with very low risk of transition to severity in confirmed covid-19. Cuba. March 2020-May 2021

Abstract

Introduction: Covid-19 pandemic, threatened health worldwide, and overhelmed systems
healthcare in many countries. Performing and adequate identification of subjects with very
low risk to develop a severe form of the disease must result very cost-effective.
Objective: To identify patients with very low risk of transition to severity in subjects
confirmed with Covid-19 in Cuba.
Methods: An environmental study was carried out based on the Cuban National Register
of confirmed Subjects covid-19. Between march 11th, 2020 and may 31st 2021, 10600
persons were recorded. Admission in ICU and mortality related to covid-19, both measured
30 days after disease confirmation, were the variables analyzed. As predictors, age and comorbidities were chosen. A classification tree – algorithm was applied to identify risk strata. To every stratum, its volume, the risk of transition to severity and the explained risk were calculated.
Results: Subjects less than 65 years with no comorbidities (85,8% of the total) had a very
low risk (0,2%) of admission in ICU and death. Adjusted models showed a good calibration and discriminant ability.
Conclusions: The study allowed the identification of subjects with very low risk of transition to severity. They could be followed by primary health care units with home surveillance and symptomatic treatment. The approaches used, permit the improvement of assigning admissions to different health care units’ optimizing limited health resources.