Biometric covariates and outcome in COVID-19 patients: are we looking close enough?

Abstract Background The 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 p...

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Autores principales:	Konstantin Sharafutdinov, Sebastian Johannes Fritsch, Gernot Marx, Johannes Bickenbach, Andreas Schuppert
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	COVID-19 SARS-CoV2 Risk factors Biometric covariates Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/f8bfb3e4f47749f882cb6485eab04ac6
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spelling	oai:doaj.org-article:f8bfb3e4f47749f882cb6485eab04ac62021-11-08T11:18:26ZBiometric covariates and outcome in COVID-19 patients: are we looking close enough?10.1186/s12879-021-06823-z1471-2334https://doaj.org/article/f8bfb3e4f47749f882cb6485eab04ac62021-11-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06823-zhttps://doaj.org/toc/1471-2334Abstract Background The 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. Methods We 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. Results We 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. Conclusions The 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.Konstantin SharafutdinovSebastian Johannes FritschGernot MarxJohannes BickenbachAndreas SchuppertBMCarticleCOVID-19SARS-CoV2Risk factorsBiometric covariatesInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 SARS-CoV2 Risk factors Biometric covariates Infectious and parasitic diseases RC109-216
spellingShingle	COVID-19 SARS-CoV2 Risk factors Biometric covariates Infectious and parasitic diseases RC109-216 Konstantin Sharafutdinov Sebastian Johannes Fritsch Gernot Marx Johannes Bickenbach Andreas Schuppert Biometric covariates and outcome in COVID-19 patients: are we looking close enough?
description	Abstract Background The 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. Methods We 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. Results We 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. Conclusions The 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.
format	article
author	Konstantin Sharafutdinov Sebastian Johannes Fritsch Gernot Marx Johannes Bickenbach Andreas Schuppert
author_facet	Konstantin Sharafutdinov Sebastian Johannes Fritsch Gernot Marx Johannes Bickenbach Andreas Schuppert
author_sort	Konstantin Sharafutdinov
title	Biometric covariates and outcome in COVID-19 patients: are we looking close enough?
title_short	Biometric covariates and outcome in COVID-19 patients: are we looking close enough?
title_full	Biometric covariates and outcome in COVID-19 patients: are we looking close enough?
title_fullStr	Biometric covariates and outcome in COVID-19 patients: are we looking close enough?
title_full_unstemmed	Biometric covariates and outcome in COVID-19 patients: are we looking close enough?
title_sort	biometric covariates and outcome in covid-19 patients: are we looking close enough?
publisher	BMC
publishDate	2021
url	https://doaj.org/article/f8bfb3e4f47749f882cb6485eab04ac6
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Biometric covariates and outcome in COVID-19 patients: are we looking close enough?

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