An external validation of the QCOVID3 risk prediction algorithm for risk of hospitalisation and death from COVID-19: An observational, prospective cohort study of 1.66m vaccinated adults in Wales, UK

Jane Lyons, Vahé Nafilyan, Ashley Akbari, Stuart Bedston, Ewen Harrison, Andrew Hayward, Julia Hippisley-Cox, Frank Kee, Kamlesh Khunti, Shamim Rahman, Aziz Sheikh, Fatemeh Torabi, Ronan A Lyons

Research output: Contribution to journalArticlepeer-review

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Abstract

Introduction
At the start of the COVID-19 pandemic there was an urgent need to identify individuals at highest risk of severe outcomes, such as hospitalisation and death following infection. The QCOVID risk prediction algorithms emerged as key tools in facilitating this which were further developed during the second wave of the COVID-19 pandemic to identify groups of people at highest risk of severe COVID-19 related outcomes following one or two doses of vaccine.

Objectives
To externally validate the QCOVID3 algorithm based on primary and secondary care records for Wales, UK.

Methods
We conducted an observational, prospective cohort based on electronic health care records for 1.66m vaccinated adults living in Wales on 8th December 2020, with follow-up until 15th June 2021. Follow-up started from day 14 post vaccination to allow the full effect of the vaccine.

Results
The scores produced by the QCOVID3 risk algorithm showed high levels of discrimination for both COVID-19 related deaths and hospital admissions and good calibration (Harrell C statistic: ≥ 0.828).

Conclusion
This validation of the updated QCOVID3 risk algorithms in the adult vaccinated Welsh population has shown that the algorithms are valid for use in the Welsh population, and applicable on a population independent of the original study, which has not been previously reported. This study provides further evidence that the QCOVID algorithms can help inform public health risk management on the ongoing surveillance and intervention to manage COVID-19 related risks.
Original languageEnglish
Article numbere0285979
JournalPLOS ONE
Volume18
Issue number5
DOIs
Publication statusPublished - 18 May 2023

Keywords

  • Humans
  • Hospitalization
  • Prospective Studies
  • Algorithms
  • Adult
  • Wales
  • Pandemics
  • COVID-19

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