ABSTRACT
Identifying prognostic biomarkers and risk stratification for COVID-19 patients is a challenging necessity. One of the core survival factors is patient age. However, chronological age is often severely biased due to dormant conditions and existing comorbidities. In this retrospective cohort study, we analyzed the data from 5315 COVID-19 patients (1689 lethal cases) admitted to 11 public hospitals in New York City from 1 March 2020 to 1 December. We calculated patients' pace of aging with BloodAge-a deep learning aging clock trained on clinical blood tests. We further constructed survival models to explore the prognostic value of biological age compared to that of chronological age. A COVID-19 score was developed to support a practical patient stratification in a clinical setting. Lethal COVID-19 cases had higher predicted age, compared to non-lethal cases (Δ = 0.8-1.6 years). Increased pace of aging was a significant risk factor of COVID-related mortality (hazard ratio = 1.026 per year, 95% CI = 1.001-1.052). According to our logistic regression model, the pace of aging had a greater impact (adjusted odds ratio = 1.09 ± 0.00, per year) than chronological age (1.04 ± 0.00, per year) on the lethal infection outcome. Our results show that a biological age measure, derived from routine clinical blood tests, adds predictive power to COVID-19 survival models.
ABSTRACT
Coronavirus disease 2019 (COVID-19) is an acute infection of the respiratory tract that emerged in December 2019 in Wuhan, China. It was quickly established that both the symptoms and the disease severity may vary from one case to another and several strains of SARS-CoV-2 have been identified. To gain a better understanding of the wide variety of SARS-CoV-2 strains and their associated symptoms, thousands of SARS-CoV-2 genomes have been sequenced in dozens of countries. In this article, we introduce COVIDomic, a multi-omics online platform designed to facilitate the analysis and interpretation of the large amount of health data collected from patients with COVID-19. The COVIDomic platform provides a comprehensive set of bioinformatic tools for the multi-modal metatranscriptomic data analysis of COVID-19 patients to determine the origin of the coronavirus strain and the expected severity of the disease. An integrative analytical workflow, which includes microbial pathogens community analysis, COVID-19 genetic epidemiology and patient stratification, allows to analyze the presence of the most common microbial organisms, their antibiotic resistance, the severity of the infection and the set of the most probable geographical locations from which the studied strain could have originated. The online platform integrates a user friendly interface which allows easy visualization of the results. We envision this tool will not only have immediate implications for management of the ongoing COVID-19 pandemic, but will also improve our readiness to respond to other infectious outbreaks.