1. Delineating COVID-19 subgroups using routine clinical data identifies distinct in-hospital outcomes
- Author
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Bojidar Rangelov, Alexandra Young, Watjana Lilaonitkul, Shahab Aslani, Paul Taylor, Eyjólfur Guðmundsson, Qianye Yang, Yipeng Hu, John R. Hurst, David J. Hawkes, Joseph Jacob, and Тhe NCCID Collaborative
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Medicine ,Science - Abstract
Abstract The COVID-19 pandemic has been a great challenge to healthcare systems worldwide. It highlighted the need for robust predictive models which can be readily deployed to uncover heterogeneities in disease course, aid decision-making and prioritise treatment. We adapted an unsupervised data-driven model—SuStaIn, to be utilised for short-term infectious disease like COVID-19, based on 11 commonly recorded clinical measures. We used 1344 patients from the National COVID-19 Chest Imaging Database (NCCID), hospitalised for RT-PCR confirmed COVID-19 disease, splitting them equally into a training and an independent validation cohort. We discovered three COVID-19 subtypes (General Haemodynamic, Renal and Immunological) and introduced disease severity stages, both of which were predictive of distinct risks of in-hospital mortality or escalation of treatment, when analysed using Cox Proportional Hazards models. A low-risk Normal-appearing subtype was also discovered. The model and our full pipeline are available online and can be adapted for future outbreaks of COVID-19 or other infectious disease.
- Published
- 2023
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