IMPORTANCEEarly identification of patients with novel coronavirus disease 2019 (COVID-19) who may develop critical illness is of great importance and may aid in delivering proper treatment and optimizing use of resources.OBJECTIVE To develop and validate a clinical score at hospital admission for predicting which patients with COVID-19 will develop critical illness based on a nationwide cohort in China. DESIGN, SETTING, AND PARTICIPANTSCollaborating with the National Health Commission of China, we established a retrospective cohort of patients with COVID-19 from 575 hospitals in 31 provincial administrative regions as of January 31, 2020. Epidemiological, clinical, laboratory, and imaging variables ascertained at hospital admission were screened using Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression to construct a predictive risk score (COVID-GRAM). The score provides an estimate of the risk that a hospitalized patient with COVID-19 will develop critical illness. Accuracy of the score was measured by the area under the receiver operating characteristic curve (AUC). Data from 4 additional cohorts in China hospitalized with COVID-19 were used to validate the score. Data were analyzed between February 20, 2020 and March 17, 2020.MAIN OUTCOMES AND MEASURES Among patients with COVID-19 admitted to the hospital, critical illness was defined as the composite measure of admission to the intensive care unit, invasive ventilation, or death. RESULTSThe development cohort included 1590 patients. the mean (SD) age of patients in the cohort was 48.9 (15.7) years; 904 (57.3%) were men. The validation cohort included 710 patients with a mean (SD) age of 48.2 (15.2) years, and 382 (53.8%) were men and 172 (24.2%). From 72 potential predictors, 10 variables were independent predictive factors and were included in the risk score: chest radiographic abnormality (

The sudden deterioration of patients with novel coronavirus disease 2019 (COVID-19) into critical illness is of major concern. It is imperative to identify these patients early. We show that a deep learning-based survival model can predict the risk of COVID-19 patients developing critical illness based on clinical characteristics at admission. We develop this model using a cohort of 1590 patients from 575 medical centers, with internal validation performance of concordance index 0.894 We further validate the model on three separate cohorts from Wuhan, Hubei and Guangdong provinces consisting of 1393 patients with concordance indexes of 0.890, 0.852 and 0.967 respectively. This model is used to create an online calculation tool designed for patient triage at admission to identify patients at risk of severe illness, ensuring that patients at greatest risk of severe illness receive appropriate care as early as possible and allow for effective allocation of health resources.

To understand the emotional changes in the elderly population during the pneumonia epidemic caused by novel coronavirus infection, and to lay a foundation for the study Haibo Yang conceived the idea for the Article.

The geospatial sciences face grand information technology (IT) challenges in the twenty-first century: data intensity, computing intensity, concurrent access intensity and spatiotemporal intensity. These challenges require the readiness of a computing infrastructure that can: (1) better support discovery, access and utilization of data and data processing so as to relieve scientists and engineers of IT tasks and focus on scientific discoveries; (2) provide real-time IT resources to enable real-time applications, such as emergency response; (3) deal with access spikes; and (4) provide more reliable and scalable service for massive numbers of concurrent users to advance public knowledge. The emergence of cloud computing provides a potential solution with an elastic, on-demand computing platform to integrate Á observation systems, parameter extracting algorithms, phenomena simulations, analytical visualization and decision support, and to provide social impact and user feedback Á the essential elements of the geospatial sciences. We discuss the utilization of cloud computing to support the intensities of geospatial sciences by reporting from our investigations on how cloud computing could enable the geospatial sciences and how spatiotemporal principles, the kernel of the geospatial sciences, could be utilized to ensure the benefits of cloud computing. Four research examples are presented to analyze how to: (1) search, access and utilize geospatial data; (2) configure computing infrastructure to enable the computability of intensive simulation models; (3) disseminate and utilize research results for massive numbers of concurrent users; and (4) adopt spatiotemporal principles to support spatiotemporal intensive applications. The paper concludes with a discussion of opportunities and challenges for spatial cloud computing (SCC).