Identification of Distinct Clinical Subphenotypes in Critically Ill Patients With COVID-19.

Chest
Charles R VasquezSTOP-COVID Investigators

Abstract

Subphenotypes have been identified in patients with sepsis and ARDS and are associated with different outcomes and responses to therapies. Can unique subphenotypes be identified among critically ill patients with COVID-19? Using data from a multicenter cohort study that enrolled critically ill patients with COVID-19 from 67 hospitals across the United States, we randomly divided centers into discovery and replication cohorts. We used latent class analysis independently in each cohort to identify subphenotypes based on clinical and laboratory variables. We then analyzed the associations of subphenotypes with 28-day mortality. Latent class analysis identified four subphenotypes (SP) with consistent characteristics across the discovery (45 centers; n = 2,188) and replication (22 centers; n = 1,112) cohorts. SP1 was characterized by shock, acidemia, and multiorgan dysfunction, including acute kidney injury treated with renal replacement therapy. SP2 was characterized by high C-reactive protein, early need for mechanical ventilation, and the highest rate of ARDS. SP3 showed the highest burden of chronic diseases, whereas SP4 demonstrated limited chronic disease burden and mild physiologic abnormalities. Twenty-eight-day mortality in...Continue Reading

References

Mar 23, 2004·American Journal of Epidemiology·Guangyong Zou
Nov 10, 2010·Nature Reviews. Cardiology·Anh L BuiGregg C Fonarow
Apr 10, 2014·Annals of the American Thoracic Society·John P ReillyJason D Christie
May 24, 2014·The Lancet. Respiratory Medicine·Carolyn S CalfeeUNKNOWN NHLBI ARDS Network
Feb 27, 2016·The Lancet. Respiratory Medicine·Emma E DavenportJulian C Knight
Jan 1, 2015·Nature Reviews. Disease Primers·Alisa S WolbergNigel Mackman
Aug 12, 2016·American Journal of Respiratory and Critical Care Medicine·Katie R FamousUNKNOWN ARDS Network
Mar 1, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Jesse Yenchih HsuUNKNOWN Chronic Renal Insufficiency Cohort (CRIC) Study Investigators
Aug 10, 2017·The New England Journal of Medicine·B Taylor ThompsonKathleen D Liu
Sep 3, 2017·The Lancet. Respiratory Medicine·Brendon P SciclunaUNKNOWN MARS consortium
Oct 17, 2017·American Journal of Infection Control·Alba Luz Rodríguez-AcelasWilson Cañon-Montañez
Apr 28, 2018·American Journal of Respiratory and Critical Care Medicine·Michael O HarhayGavin C Donaldson
Aug 7, 2018·The Lancet. Respiratory Medicine·Carolyn S CalfeeUNKNOWN Irish Critical Care Trials Group
Aug 24, 2018·Nature Reviews. Nephrology·Eric A J HosteLakhmir S Chawla
Oct 20, 2018·American Journal of Respiratory and Critical Care Medicine·Pavan K BhatrajuMark M Wurfel
May 20, 2019·JAMA : the Journal of the American Medical Association·Christopher W SeymourDerek C Angus
Apr 16, 2020·Intensive Care Medicine·Luciano GattinoniLuigi Camporota
Apr 25, 2020·JAMA : the Journal of the American Medical Association·John J Marini, Luciano Gattinoni
May 8, 2020·Critical Care : the Official Journal of the Critical Care Forum·Xu Li, Xiaochun Ma
May 28, 2020·The New England Journal of Medicine·Eboni G Price-HaywoodLeonardo Seoane
Jun 12, 2020·The Lancet. Respiratory Medicine·Kiran ReddyDaniel F McAuley
Jul 7, 2020·The Lancet Infectious Diseases·Eskild PetersenLone Simonsen
Jul 11, 2020·JAMA : the Journal of the American Medical Association·W Joost WiersingaHallie C Prescott
Jul 14, 2020·Circulation·Alex C Spyropoulos, Jeffrey I Weitz
Jul 16, 2020·JAMA Internal Medicine·Shruti GuptaUNKNOWN STOP-COVID Investigators

❮ Previous
Next ❯

Citations

Jul 23, 2021·Current Opinion in Critical Care·Fernando Jose da Silva RamosFlavia Ribeiro Machado

❮ Previous
Next ❯

Software Mentioned

Stata
STOP
IC
Excel

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.