Clinical Features and a Nomogram for Predicting Infection in Anti-MDA5 Antibody-Positive Dermatomyositis: A Single-Center Retrospective Study

Clinical Features and a Nomogram for Predicting Infection in Anti-MDA5 Antibody-Positive Dermatomyositis: A Single-Center Retrospective Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical Features and a Nomogram for Predicting Infection in Anti-MDA5 Antibody-Positive Dermatomyositis: A Single-Center Retrospective Study Min Zhang, Juan Wang, Cheng-Cong Zhu, Shuang-Shuang Song, Qian Zhang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9245436/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background : Anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis (anti-MDA5+ DM) confers substantial mortality risk, among which infection predominates. This study aimed to delineate the clinical characteristics of MDA5+ DM and develop a nomogram for infection prediction. Methods: We retrospectively analyzed clinical data from 207 consecutive hospitalized patients with anti-MDA5+ DM. Patients were divided into infected and uninfected groups. Univariate and multivariate logistic regression analyses were performed to identify potential risk factors for infection. A nomogram was constructed to visualize the predictive model, with performance assessed via receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) calculation. Results: Among 207 enrolled patients, 101 developed infections. Elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH), lower levels of albumin (Alb), diabetes, mean daily glucocorticoid dose during the month preceding admission and cyclophosphamide exposure were identified as independent risk factors for infection. The prediction model incorporating these six factors yielded an AUC of 0.856. Conclusions: Independent risk factors for infection in MDA5+ DM included elevated CRP and LDH, lower levels of Alb, diabetes,mean daily glucocorticoid dose, and cyclophosphamide exposure. The derived nomogram exhibited favorable predictive performance and may facilitate individualized risk assessment. Anti-melanoma differentiation-associated gene 5-positive dermatomyositis Clinical Characteristic Infection Nomogram Prediction model Full Text Additional Declarations No competing interests reported. Supplementary Files supplment.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 11 May, 2026 Reviews received at journal 04 May, 2026 Reviewers agreed at journal 13 Apr, 2026 Reviewers agreed at journal 12 Apr, 2026 Reviewers invited by journal 08 Apr, 2026 Editor assigned by journal 08 Apr, 2026 Editor invited by journal 07 Apr, 2026 Submission checks completed at journal 07 Apr, 2026 First submitted to journal 07 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9245436","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":622044953,"identity":"82c6b01c-8ef3-4c52-96f9-e3b32d26156e","order_by":0,"name":"Min Zhang","email":"","orcid":"","institution":"The First Affiliated Hospital (Southwest Hospital) of Army Medical University","correspondingAuthor":false,"prefix":"","firstName":"Min","middleName":"","lastName":"Zhang","suffix":""},{"id":622044955,"identity":"6688bac1-cc25-41c9-b208-0b1186c21449","order_by":1,"name":"Juan Wang","email":"","orcid":"","institution":"The First Affiliated 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Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Anti-melanoma differentiation-associated gene 5-positive dermatomyositis, Clinical Characteristic, Infection, Nomogram, Prediction model","lastPublishedDoi":"10.21203/rs.3.rs-9245436/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9245436/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eAnti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis (anti-MDA5+ DM) confers substantial mortality risk, among which infection predominates. This study aimed to delineate the clinical characteristics of MDA5+ DM and develop a nomogram for infection prediction.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe retrospectively analyzed clinical data from 207 consecutive hospitalized patients with anti-MDA5+ DM. Patients were divided into infected and uninfected groups. Univariate and multivariate logistic regression analyses were performed to identify potential risk factors for infection. A nomogram was constructed to visualize the predictive model, with performance assessed via receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) calculation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong 207 enrolled patients, 101 developed infections. Elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH), lower levels of albumin (Alb), diabetes, mean daily glucocorticoid dose during the month preceding admission and cyclophosphamide exposure were identified\u003cstrong\u003e \u003c/strong\u003eas independent risk factors for infection. The prediction model incorporating these six factors yielded an AUC of 0.856.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIndependent risk factors for infection in MDA5+ DM included elevated CRP and LDH, lower levels of Alb, diabetes,mean daily glucocorticoid dose, and cyclophosphamide exposure. 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