{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T21:35:24Z","timestamp":1782941724687,"version":"3.54.5"},"reference-count":31,"publisher":"JMIR Publications Inc.","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID-19 pandemic has placed a huge strain on the health care system globally. The metropolitan area of Milan, Italy, was one of the regions most impacted by the COVID-19 pandemic worldwide. Risk prediction models developed by combining administrative databases and basic clinical data are needed to stratify individual patient risk for public health purposes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to develop a stratification tool aimed at improving COVID-19 patient management and health care organization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A predictive algorithm was developed and applied to 36,834 patients with COVID-19 in Italy between March 8 and the October 9, 2020, in order to foresee their risk of hospitalization. Exposures considered were age, sex, comorbidities, and symptoms associated with COVID-19 (eg, vomiting, cough, fever, diarrhea, myalgia, asthenia, headache, anosmia, ageusia, and dyspnea). The outcome was hospitalizations and emergency department admissions for COVID-19. Discrimination and calibration of the model were also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The predictive model showed a good fit for predicting COVID-19 hospitalization (C-index 0.79) and a good overall prediction accuracy (Brier score 0.14). The model was well calibrated (intercept \u20130.0028, slope 0.9970). Based on these results, 118,804 patients diagnosed with COVID-19 from October 25 to December 11, 2020, were stratified into low, medium, and high risk for COVID-19 severity. Among the overall study population, 67,030 (56.42%) were classified as low-risk patients; 43,886 (36.94%), as medium-risk patients; and 7888 (6.64%), as high-risk patients. In all, 89.37% (106,179\/118,804) of the overall study population was being assisted at home, 9% (10,695\/118,804) was hospitalized, and 1.62% (1930\/118,804) died. Among those assisted at home, most people (63,983\/106,179, 60.26%) were classified as low risk, whereas only 3.63% (3858\/106,179) were classified at high risk. According to ordinal logistic regression, the odds ratio (OR) of being hospitalized or dead was 5.0 (95% CI 4.6-5.4) among high-risk patients and 2.7 (95% CI 2.6-2.9) among medium-risk patients, as compared to low-risk patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A simple monitoring system, based on primary care data sets linked to COVID-19 testing results, hospital admissions data, and death records may assist in the proper planning and allocation of patients and resources during the ongoing COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/29504","type":"journal-article","created":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T10:29:27Z","timestamp":1631615367000},"page":"e29504","source":"Crossref","is-referenced-by-count":12,"title":["Algorithm for Individual Prediction of COVID-19\u2013Related Hospitalization Based on Symptoms: Development and Implementation Study"],"prefix":"10.2196","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8989-7605","authenticated-orcid":false,"given":"Rossella","family":"Murtas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1070-8857","authenticated-orcid":false,"given":"Nuccia","family":"Morici","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2980-6158","authenticated-orcid":false,"given":"Chiara","family":"Cogliati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3278-7138","authenticated-orcid":false,"given":"Massimo","family":"Puoti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2273-5836","authenticated-orcid":false,"given":"Barbara","family":"Omazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3025-2271","authenticated-orcid":false,"given":"Walter","family":"Bergamaschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7309-6929","authenticated-orcid":false,"given":"Antonio","family":"Voza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2615-3649","authenticated-orcid":false,"given":"Patrizia","family":"Rovere Querini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3558-6967","authenticated-orcid":false,"given":"Giulio","family":"Stefanini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5490-7367","authenticated-orcid":false,"given":"Maria Grazia","family":"Manfredi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2330-9521","authenticated-orcid":false,"given":"Maria Teresa","family":"Zocchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4415-8040","authenticated-orcid":false,"given":"Andrea","family":"Mangiagalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0461-1100","authenticated-orcid":false,"given":"Carla Vittoria","family":"Brambilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7074-5436","authenticated-orcid":false,"given":"Marco","family":"Bosio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4756-3612","authenticated-orcid":false,"given":"Matteo","family":"Corradin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5182-9837","authenticated-orcid":false,"given":"Francesca","family":"Cortellaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2709-943X","authenticated-orcid":false,"given":"Marco","family":"Trivelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1216-0784","authenticated-orcid":false,"given":"Stefano","family":"Savonitto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5681-5861","authenticated-orcid":false,"given":"Antonio Giampiero","family":"Russo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"key":"ref1","unstructured":"COVID-19 MapJohns Hopkins Coronavirus Resource Center2021-10-29https:\/\/coronavirus.jhu.edu\/map.html"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1328"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.2196\/23897"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m3731"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2020.11.025"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-046044"},{"key":"ref7","unstructured":"World Medical Association Declaration of Helsinki \u2013 Ethical Principles for Medical Research Involving Human SubjectsJAMA Network201311272021-02-01https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/1760318"},{"key":"ref8","unstructured":"Provvedimento del Garante n. 2 del 16 giugno. Codice di deontologia e di buona condotta per i trattamenti di dati personali per scopi statistici e scientifici. Webpage in ItalianGazzetta Ufficiale n 190, 14 agosto200408142021-11-03https:\/\/www.gazzettaufficiale.it\/eli\/gu\/2004\/08\/14\/190\/so\/141\/sg\/pdf"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1186\/s12575-020-00128-2"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.24875\/BMHIM.20000183"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13620"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0234765"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.03.041"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820926473"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2020.05.030"},{"key":"ref16","unstructured":"International Classification of Diseases, Ninth Revision, Clinical ModificationCentre for Disease Control and Prevention20192021-10-29https:\/\/www.cdc.gov\/nchs\/icd\/icd9cm.htm"},{"key":"ref17","unstructured":"Attivazione della presa in carico dei pazienti cronici e fragili: DGR n. X\/6164 del 30 Gennaio 2017. Webpage in ItalianRegione Lombardia2021-11-03https:\/\/www.regione.lombardia.it\/wps\/portal\/istituzionale\/HP\/DettaglioRedazionale\/servizi-e-informazioni\/Enti-e-Operatori\/sistema-welfare\/attuazione-della-riforma-sociosanitaria-lombarda\/avvio-presa-carico-pazienti-cronici-fragili\/dgr2017-6164-avvio-presa-carico-pazienti-cronici-fragili"},{"key":"ref18","unstructured":"Avvio del percorso di presa in carico dei pazienti cronici e fragili: DGR n. X\/7655 del 28. Webpage in ItalianRegione Lombardia2021-11-03https:\/\/www.regione.lombardia.it\/wps\/portal\/istituzionale\/HP\/DettaglioRedazionale\/servizi-e-informazioni\/Enti-e-Operatori\/sistema-welfare\/attuazione-della-riforma-sociosanitaria-lombarda\/dgr2017-7655-avvio-presa-carico-cronici\/dgr2017-7655-avvio-presa-carico-cronici"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.7326\/M14-0698"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/s0895-4356(01)00341-9"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1097-0258(19960229)15:4<361::aid-sim168>3.0.co;2-4"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.11919\/j.issn.1002-0829.218052"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2019.09.016"},{"key":"ref24","unstructured":"Using Logistic Regression to Model and Predict Categorical ValuesOpenIntro Lab2021-11-03http:\/\/rstudio-pubs-static.s3.amazonaws.com\/74431_8cbd662559f6451f9cd411545f28107f.html"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.19191\/EP21.1-2.P100.044"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2035002"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2029849"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2033700"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyaa209"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.idm.2020.03.001"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2021.01.028"}],"container-title":["JMIR Public Health and Surveillance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publichealth.jmir.org\/2021\/11\/e29504","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:44:19Z","timestamp":1782841459000},"score":1,"resource":{"primary":{"URL":"https:\/\/publichealth.jmir.org\/2021\/11\/e29504"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,15]]},"references-count":31,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.2196\/29504","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.29504","asserted-by":"object"}]},"ISSN":["2369-2960"],"issn-type":[{"value":"2369-2960","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,15]]}}}