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Phenome-wide association of 1809 phenotypes and COVID-19 disease progression in the Veterans Health Administration Million Veteran Program.
Song, Rebecca J; Ho, Yuk-Lam; Schubert, Petra; Park, Yojin; Posner, Daniel; Lord, Emily M; Costa, Lauren; Gerlovin, Hanna; Kurgansky, Katherine E; Anglin-Foote, Tori; DuVall, Scott; Huffman, Jennifer E; Pyarajan, Saiju; Beckham, Jean C; Chang, Kyong-Mi; Liao, Katherine P; Djousse, Luc; Gagnon, David R; Whitbourne, Stacey B; Ramoni, Rachel; Muralidhar, Sumitra; Tsao, Philip S; O'Donnell, Christopher J; Gaziano, John Michael; Casas, Juan P; Cho, Kelly.
  • Song RJ; Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America.
  • Ho YL; Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States of America.
  • Schubert P; Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America.
  • Park Y; Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America.
  • Posner D; Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America.
  • Lord EM; Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America.
  • Costa L; Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America.
  • Gerlovin H; Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America.
  • Kurgansky KE; Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America.
  • Anglin-Foote T; Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America.
  • DuVall S; VA Salt Lake City Health Care System, Salt Lake City, Utah, United States of America.
  • Huffman JE; VA Salt Lake City Health Care System, Salt Lake City, Utah, United States of America.
  • Pyarajan S; Office of Research and Development, Veterans Health Administration, Washington, DC, United States of America.
  • Beckham JC; Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States of America.
  • Chang KM; Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America.
  • Liao KP; Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America.
  • Djousse L; Department of Medicine, Division of Aging, Brigham & Women's Hospital, Boston, Massachusetts, United States of America.
  • Gagnon DR; Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America.
  • Whitbourne SB; Durham VA Medical Center, Durham, North Carolina, United States of America.
  • Ramoni R; Department of Psychiatry and Behavioral Sciences, University Medical Center, Durham, North Carolina, United States of America.
  • Muralidhar S; VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, North Carolina, United States of America.
  • Tsao PS; Corporal Michael Crescenz VA Medical Center, Philadelphia, Pennsylvania, United States of America.
  • O'Donnell CJ; Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
  • Gaziano JM; Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America.
  • Casas JP; Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America.
  • Cho K; Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America.
PLoS One ; 16(5): e0251651, 2021.
Article in English | MEDLINE | ID: covidwho-1226903
Semantic information from SemMedBD (by NLM)
1. Coitus AFFECTS Age
Subject
Coitus
Predicate
AFFECTS
Object
Age
2. American College of Cardiology/American Heart Association Lesion Complexity Score A PROCESS_OF Woman
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score A
Predicate
PROCESS_OF
Object
Woman
3. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF African race
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
African race
4. Increased risk COEXISTS_WITH Bacterial Infections
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
Bacterial Infections
5. Increased risk COEXISTS_WITH Hydronephrosis
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
Hydronephrosis
6. Increased risk COEXISTS_WITH Leukocyte Disorders
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
Leukocyte Disorders
7. Increased risk COEXISTS_WITH Morbid obesity
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
Morbid obesity
8. Increased risk COEXISTS_WITH Kidney Failure
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
Kidney Failure
9. Increased risk COEXISTS_WITH acid base disorder
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
acid base disorder
10. Increased risk COEXISTS_WITH Respiratory Failure
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
Respiratory Failure
11. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
12. Coitus AFFECTS Age
Subject
Coitus
Predicate
AFFECTS
Object
Age
13. American College of Cardiology/American Heart Association Lesion Complexity Score A PROCESS_OF Woman
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score A
Predicate
PROCESS_OF
Object
Woman
14. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF African race
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
African race
15. Increased risk COEXISTS_WITH Bacterial Infections
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
Bacterial Infections
16. Increased risk COEXISTS_WITH Hydronephrosis
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
Hydronephrosis
17. Increased risk COEXISTS_WITH Leukocyte Disorders
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
Leukocyte Disorders
18. Increased risk COEXISTS_WITH Morbid obesity
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
Morbid obesity
19. Increased risk COEXISTS_WITH Kidney Failure
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
Kidney Failure
20. Increased risk COEXISTS_WITH acid base disorder
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
acid base disorder
21. Increased risk COEXISTS_WITH Respiratory Failure
Subject
Increased risk
Predicate
COEXISTS_WITH
Object
Respiratory Failure
22. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

BACKGROUND:

The risk factors associated with the stages of Coronavirus Disease-2019 (COVID-19) disease progression are not well known. We aim to identify risk factors specific to each state of COVID-19 progression from SARS-CoV-2 infection through death. METHODS AND

RESULTS:

We included 648,202 participants from the Veteran Affairs Million Veteran Program (2011-). We identified characteristics and 1,809 ICD code-based phenotypes from the electronic health record. We used logistic regression to examine the association of age, sex, body mass index (BMI), race, and prevalent phenotypes to the stages of COVID-19 disease progression infection, hospitalization, intensive care unit (ICU) admission, and 30-day mortality (separate models for each). Models were adjusted for age, sex, race, ethnicity, number of visit months and ICD codes, state infection rate and controlled for multiple testing using false discovery rate (≤0.1). As of August 10, 2020, 5,929 individuals were SARS-CoV-2 positive and among those, 1,463 (25%) were hospitalized, 579 (10%) were in ICU, and 398 (7%) died. We observed a lower risk in women vs. men for ICU and mortality (Odds Ratio (95% CI) 0.48 (0.30-0.76) and 0.59 (0.31-1.15), respectively) and a higher risk in Black vs. Other race patients for hospitalization and ICU (OR (95%CI) 1.53 (1.32-1.77) and 1.63 (1.32-2.02), respectively). We observed an increased risk of all COVID-19 disease states with older age and BMI ≥35 vs. 20-24 kg/m2. Renal failure, respiratory failure, morbid obesity, acid-base balance disorder, white blood cell diseases, hydronephrosis and bacterial infections were associated with an increased risk of ICU admissions; sepsis, chronic skin ulcers, acid-base balance disorder and acidosis were associated with mortality.

CONCLUSIONS:

Older age, higher BMI, males and patients with a history of respiratory, kidney, bacterial or metabolic comorbidities experienced greater COVID-19 severity. Future studies to investigate the underlying mechanisms associated with these phenotype clusters and COVID-19 are warranted.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Veterans Health / COVID-19 Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0251651

Full text: Available Collection: International databases Database: MEDLINE Main subject: Veterans Health / COVID-19 Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0251651