Sharafutdinov, Konstantin
[Verfasser:in];
Fritsch, Sebastian Johannes
[Verfasser:in];
Marx, Gernot
[Verfasser:in];
Bickenbach, Johannes
[Verfasser:in];
Schuppert, Andreas
[Verfasser:in]
Biometric covariates and outcome in COVID-19 patients: are we looking close enough?
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Medientyp:
E-Artikel
Titel:
Biometric covariates and outcome in COVID-19 patients: are we looking close enough?
Beteiligte:
Sharafutdinov, Konstantin
[Verfasser:in];
Fritsch, Sebastian Johannes
[Verfasser:in];
Marx, Gernot
[Verfasser:in];
Bickenbach, Johannes
[Verfasser:in];
Schuppert, Andreas
[Verfasser:in]
Anmerkungen:
Diese Datenquelle enthält auch Bestandsnachweise, die nicht zu einem Volltext führen.
Beschreibung:
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, ...