Your browser doesn't support javascript.
Identification of Endotypes of Hospitalized COVID-19 Patients.
Ranard, Benjamin L; Megjhani, Murad; Terilli, Kalijah; Doyle, Kevin; Claassen, Jan; Pinsky, Michael R; Clermont, Gilles; Vodovotz, Yoram; Asgari, Shadnaz; Park, Soojin.
  • Ranard BL; Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, United States.
  • Megjhani M; Program for Hospital and Intensive Care Informatics, Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States.
  • Terilli K; Program for Hospital and Intensive Care Informatics, Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States.
  • Doyle K; Department of Neurology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, United States.
  • Claassen J; Program for Hospital and Intensive Care Informatics, Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States.
  • Pinsky MR; Department of Neurology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, United States.
  • Clermont G; Department of Neurology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, United States.
  • Vodovotz Y; Department of Neurology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, United States.
  • Asgari S; Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
  • Park S; Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
Front Med (Lausanne) ; 8: 770343, 2021.
Article in English | MEDLINE | ID: covidwho-1551517
ABSTRACT

Background:

Characterization of coronavirus disease 2019 (COVID-19) endotypes may help explain variable clinical presentations and response to treatments. While risk factors for COVID-19 have been described, COVID-19 endotypes have not been elucidated.

Objectives:

We sought to identify and describe COVID-19 endotypes of hospitalized patients.

Methods:

Consensus clustering (using the ensemble method) of patient age and laboratory values during admission identified endotypes. We analyzed data from 528 patients with COVID-19 who were admitted to telemetry capable beds at Columbia University Irving Medical Center and discharged between March 12 to July 15, 2020.

Results:

Four unique endotypes were identified and described by laboratory values, demographics, outcomes, and treatments. Endotypes 1 and 2 were comprised of low numbers of intubated patients (1 and 6%) and exhibited low mortality (1 and 6%), whereas endotypes 3 and 4 included high numbers of intubated patients (72 and 85%) with elevated mortality (21 and 43%). Endotypes 2 and 4 had the most comorbidities. Endotype 1 patients had low levels of inflammatory markers (ferritin, IL-6, CRP, LDH), low infectious markers (WBC, procalcitonin), and low degree of coagulopathy (PTT, PT), while endotype 4 had higher levels of those markers.

Conclusions:

Four unique endotypes of hospitalized patients with COVID-19 were identified, which segregated patients based on inflammatory markers, infectious markers, evidence of end-organ dysfunction, comorbidities, and outcomes. High comorbidities did not associate with poor outcome endotypes. Further work is needed to validate these endotypes in other cohorts and to study endotype differences to treatment responses.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article Affiliation country: Fmed.2021.770343

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article Affiliation country: Fmed.2021.770343