Journal Article

FZJ-2021-04122

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Biometric covariates and outcome in COVID-19 patients: are we looking close enough?

Sharafutdinov, K. ; Fritsch, S. J. (Corresponding author)FZJ* ; Marx, G. ; Bickenbach, J. ; Schuppert, A.

2021
Springer Heidelberg

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Please use a persistent id in citations: http://hdl.handle.net/2128/29032  doi:10.1186/s12879-021-06823-z

Abstract: BackgroundThe impact of biometric covariates on risk for adverse outcomes of COVID-19 disease was assessed by numerous observational studies on unstratified cohorts, which show great heterogeneity. However, multilevel evaluations to find possible complex, e.g. non-monotonic multi-variate patterns reflecting mutual interference of parameters are missing. We used a more detailed, computational analysis to investigate the influence of biometric differences on mortality and disease evolution among severely ill COVID-19 patients.MethodsWe analyzed a group of COVID-19 patients requiring Intensive care unit (ICU) treatment. For further analysis, the study group was segmented into six subgroups according to Body mass index (BMI) and age. To link the BMI/age derived subgroups with risk factors, we performed an enrichment analysis of diagnostic parameters and comorbidities. To suppress spurious patterns, multiple segmentations were analyzed and integrated into a consensus score for each analysis step.ResultsWe analyzed 81 COVID-19 patients, of whom 67 required mechanical ventilation (MV). Mean mortality was 35.8%. We found a complex, non-monotonic interaction between age, BMI and mortality. A subcohort of patients with younger age and intermediate BMI exhibited a strongly reduced mortality risk (p < 0.001), while differences in all other groups were not significant. Univariate impacts of BMI or age on mortality were missing. Comparing MV with non-MV patients, we found an enrichment of baseline CRP, PCT and D-Dimers within the MV group, but not when comparing survivors vs. non-survivors within the MV patient group.ConclusionsThe aim of this study was to get a more detailed insight into the influence of biometric covariates on the outcome of COVID-19 patients with high degree of severity. We found that survival in MV is affected by complex interactions of covariates differing to the reported covariates, which are hidden in generic, non-stratified studies on risk factors. Hence, our study suggests that a detailed, multivariate pattern analysis on larger patient cohorts reflecting the specific disease stages might reveal more specific patterns of risk factors supporting individually adapted treatment strategies.

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Contributing Institute(s):

1. Jülich Supercomputing Center (JSC)

Research Program(s):

1. 5112 - Cross-Domain Algorithms, Tools, Methods Labs (ATMLs) and Research Groups (POF4-511) (POF4-511)
2. SMITH - Medizininformatik-Konsortium - Beitrag Forschungszentrum Jülich (01ZZ1803M) (01ZZ1803M)

Appears in the scientific report 2021

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