Delineating COVID-19 subgroups using routine clinical data identifies distinct in-hospital outcomes

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.

Metadata

Item Type:	Article
Authors/Creators:	This paper has 100 authors. You can scroll the list below to see them all or them all. Rangelov, B. https://orcid.org/0000-0001-7017-1575 Young, A. https://orcid.org/0000-0002-7772-781X Lilaonitkul, W. Aslani, S. Taylor, P. Guðmundsson, E. Yang, Q. Hu, Y. Hurst, J.R. Hawkes, D.J. Jacob, J. Cushnan, D. Halling-Brown, M. Jacob, J. Jefferson, E. Lemarchand, F. Sarellas, A. Schofield, D. Sutherland, J. Watt, M. Alexander, D. Aziz, H. Hurst, J.R. Lewis, E. Lip, G. Manser, P. Quinlan, P. Sebire, N. Swift, A. Shetty, S. Williams, P. Bennett, O. Dorgham, S. Favaro, A. Gan, S. Ganepola, T. Imreh, G. Puri, N. Rodrigues, J.L.C. Oliver, H. Hudson, B. Robinson, G. Wood, R. Moreton, A. Lomas, K. Marchbank, N. Law, C. Chana, H. Gandy, N. Sharif, B. Ismail, L. Patel, J. Wai, D. Mathers, L. Clark, R. Harrar, A. Bettany, A. Foley, K. Pothecary, C. Buckle, S. Roche, L. Shah, A. Kirkham, F. Bown, H. Seal, S. Connoley, H. Tugwell-Allsup, J. Owen, W.B. Jones, M. Moth, A. Colman, J. Maskell, G. Kim, D. Sanchez-Cabello, A. Lewis, H. Thorley, M. Kruger, R. Chifu, M. Ashley, N. Spas, S. Bates, A. Halson, P. Heafey, C. McCann, C. McCreavy, D. Duvva, D. Siah, T. Deane, J. Pearlman, E. MacKay, J. Sia, M. Easter, E. Brookes, D. Burford, P. Barbara, R.R. Payne, T. Ingram, M. Bhatia, B. Yusuf, S. Rotherham, F.
Copyright, Publisher and Additional Information:	© The Author(s) 2023. This is an open access article under the terms of the Creative Commons Attribution License (CC-BY 4.0), which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited.
Dates:	Published: 20 June 2023 Published (online): 20 June 2023 Accepted: 28 March 2023
Institution:	The University of Leeds
Academic Units:	The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Inst of Biomed & Clin Sciences (LIBACS) (Leeds)
Depositing User:	Symplectic Publications
Date Deposited:	06 Sep 2023 10:16
Last Modified:	06 Sep 2023 10:16
Status:	Published
Publisher:	Nature Research
Identification Number:	10.1038/s41598-023-32469-9
Related URLs:	PubMed URL
Open Archives Initiative ID (OAI ID):	oai:eprints.whiterose.ac.uk:203088

Commentary/Response Threads

Rangelov, B., Young, A., Lilaonitkul, W., Aslani, S., Taylor, P., Guðmundsson, E., Yang, Q., Hu, Y., Hurst, J.R., Hawkes, D.J., Jacob, J., Cushnan, D., Halling-Brown, M., Jacob, J., Jefferson, E., Lemarchand, F., Sarellas, A., Schofield, D., Sutherland, J., Watt, M., Alexander, D., Aziz, H., Hurst, J.R., Lewis, E., Lip, G., Manser, P., Quinlan, P., Sebire, N., Swift, A., Shetty, S., Williams, P., Bennett, O., Dorgham, S., Favaro, A., Gan, S., Ganepola, T., Imreh, G., Puri, N., Rodrigues, J.L.C., Oliver, H., Hudson, B., Robinson, G., Wood, R., Moreton, A., Lomas, K., Marchbank, N., Law, C., Chana, H., Gandy, N., Sharif, B., Ismail, L., Patel, J., Wai, D., Mathers, L., Clark, R., Harrar, A., Bettany, A., Foley, K., Pothecary, C., Buckle, S., Roche, L., Shah, A., Kirkham, F., Bown, H., Seal, S., Connoley, H., Tugwell-Allsup, J., Owen, W.B., Jones, M., Moth, A., Colman, J., Maskell, G., Kim, D., Sanchez-Cabello, A., Lewis, H., Thorley, M., Kruger, R., Chifu, M., Ashley, N., Spas, S., Bates, A., Halson, P., Heafey, C., McCann, C., McCreavy, D., Duvva, D., Siah, T., Deane, J., Pearlman, E., MacKay, J., Sia, M., Easter, E., Brookes, D., Burford, P., Barbara, R.R., Payne, T., Ingram, M., Bhatia, B., Yusuf, S. and Rotherham, F. Delineating COVID-19 subgroups using routine clinical data identifies distinct in-hospital outcomes. (deposited 06 Sep 2023 10:16) [Currently Displayed]
- Rangelov, B., Young, A., Lilaonitkul, W., Aslani, S., Taylor, P., Guðmundsson, E., Yang, Q., Hu, Y., Hurst, J.R., Hawkes, D.J., Jacob, J., Bains, P., Cushnan, D., Halling-Brown, M., Jacob, J., Jefferson, E., Lemarchand, F., Sarellas, A., Schofield, D., Sutherland, J., Watt, M., Alexander, D., Aziz, H., Hurst, J.R., Lewis, E., Lip, G., Manser, P., Quinlan, P., Sebire, N., Swift, A., Shetty, S., Williams, P., Bennett, O., Dorgham, S., Favaro, A., Gan, S., Ganepola, T., Imreh, G., Puri, N., Rodrigues, J.C.L., Oliver, H., Hudson, B., Robinson, G., Wood, R., Moreton, A., Lomas, K., Marchbank, N., Law, C., Chana, H., Gandy, N., Sharif, B., Ismail, L., Patel, J., Wai, D., Mathers, L., Clark, R., Harrar, A., Bettany, A., Foley, K., Pothecary, C., Buckle, S., Roche, L., Shah, A., Kirkham, F., Bown, H., Seal, S., Connoley, H., Tugwell-Allsup, J., Owen, B.W., Jones, M., Moth, A., Colman, J., Maskell, G., Kim, D., Sanchez-Cabello, A., Lewis, H., Thorley, M., Kruger, R., Chifu, M., Ashley, N., Spas, S., Bates, A., Halson, P., Heafey, C., McCann, C., McCreavy, D., Duvva, D., Siah, T., Deane, J., Pearlman, E., MacKay, J., Sia, M., Easter, E., Brookes, D., Burford, P., Barbara, R.-R., Payne, T., Ingram, M., Bhatia, B., Yusuf, S., Rotherham, F., Warren, G., Heeney, A., Bowen, A., Wilson, A., Hussain, Z., Kellett, J., Harrison, R., Watkins, J., Patterson, L., Welsh, T., Redwood, D., Greig, N., Van Pelt, L., Palmer, S., Milne, K., Tilley, J., Alexander, M., Frary, A.J., Babar, J.L., Sadler, T., Neil-Gallacher, E., Cardona, S., Gill, A., Omeje, N., Ridgeon, C., Gleeson, F., Johnstone, A., Frood, R., Rabani, M.A., Scarsbrook, A., Lyttle, M.D., Lyen, S., James, G., Sheedy, S., Homer, K., Glover, A., Gibbison, B., Blazeby, J., Baquedano, M., Payne, T., Jacob, T., Grubnic, S., Crick, T., Crawford, D., Prestwood, F., Cooper, M. and Radon, M. Author Correction: Delineating COVID-19 subgroups using routine clinical data identifies distinct in-hospital outcomes. (deposited 07 Dec 2023 13:42)

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