Science & Technology

COVID-19 patients can be divided into 3 groups – here are 3 phenotypes

Phenotypic clinical outcome. The code diagram shows the prevalence (observed%) of clinical outcomes of the three clinical phenotypes. Abbreviations: ICU (Intensive Care Unit); Vent (Mechanical Ventilation); Re-hospitalization (Re-hospitalization to hospital or ICU); ECMO (Extracorporeal Membrane Oxygenation). Credits: Lusczek et al, 2021, PLOS ONE (CC-BY 4.0)

Phenotypes I, II, and III show distinct characteristics with adverse, normal, and favorable clinical outcomes, respectively.

In a new study, researchers identify three clinical clinics COVID-19 (new coronavirus infection) A phenotype that reflects a population of patients with various comorbidities, complications, and clinical outcomes. The three phenotypes appear in a paper published in an open access journal this week. PLOS ONE Lead authors Elizabeth Rusek and Nicholas Ingraham, University of Minnesota School of Medicine, USA, and colleagues.

COVID-19 has infected more than 18 million people and killed more than 700,000 people worldwide. The symptoms of the emergency department are very different, suggesting that different clinical phenotypes exist and, importantly, that these different phenotypes may respond differently to treatment.

In a new study, researchers analyzed electronic health records (EHRs) from 14 hospitals in the Midwestern United States and 60 primary care clinics in Minnesota. Data from 7,538 patients with COVID-19 confirmed by PCR between March 7, 2020 and August 25, 2020 were available. Of these patients, 1,022 required hospitalization and were included in the study. Each patient’s data included comorbidities, medications, laboratory values, clinic visits, hospitalization information, and patient demographics.

Most of the patients included in the study (613 patients, or 60 percent) presented what the researchers called “phenotype II.” 236 patients (23.1 percent) exhibited “phenotype I” or “harmful phenotype”, which was associated with the worst clinical outcome. These patients had the highest levels of hematological, renal, and cardiac comorbidities (all p <0.001) and were more likely to speak non-white and non-English. 173 patients (16.9 percent) showed "phenotype III" or "favorable phenotype", which was associated with the best clinical outcome. Surprisingly, despite the lowest incidence and mortality of complications, patients in this group have the highest incidence of respiratory complications (p = 0.002) compared to other phenotypes. The risk of readmission was 10% higher. Overall, phenotypes I and II are 7.30 times (95% CI 3.11-17.17, p <0.001) and 2.57 times (95% CI 1.10-6.00, p = 0.03) mortality risk compared to phenotype III. It was associated with increased sex.

The authors conclude that phenotype-specific medicine may improve the outcome of COVID-19, and further research is needed to determine the usefulness of these findings in clinical practice. It suggests that there is.

The author adds: “Patients do not suffer from COVID-19 with uniform problems. Similarly, identifying affected groups not only provides a better understanding of the disease process, but also accurately addresses future interventions to the most risky patients. Can be targeted to. “

Reference: “COVID-19 Clinical” by Elizabeth R. Rusek, Nicholas E. Ingraham, Basil S. Karam, Jennifer Proper, Lian Siegel, Erica S. Helgeson, Sahar Rotophie Emuran, Emily J. Phenotype and related comorbidities and complication profile characterization “. Zolfaghari, Emma Jones, Michael G. Usher, Jeffrey G. Chipman, R. Adams Dudley, Bradley Benson, Genevieve B. Melton, Anthony Charles, Monica I. Lupei, Christopher J. Tignanelli, March 31, 2021 PLoS ONE..
DOI: 10.1371 / journal.pone.0248956

Funds: 1. NIH National Institute of Cardiopulmonary Blood T32HL07741 (NEI) 2. This study was supported by the Agency for Healthcare Research and Quality (AHRQ), the Patient-Centered Outcomes Institute (PCORI), and grant K12HS026379 (CJT). The National Center for Advancing Translational Sciences of the National Institutes of Health grants UL1TR002494. 3. NIH National Heart, Lung, and Blood Institute T32HL129956 (JP, LS) Funders were not involved in study design, data collection and analysis, publication decisions, or manuscript preparation.

COVID-19 patients can be divided into 3 groups – here are 3 phenotypes COVID-19 patients can be divided into 3 groups – here are 3 phenotypes

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