Evolving phenotypes of non-hospitalized patients that indicate long COVID.
Evolving phenotypes of non-hospitalized patients that indicate long COVID.
复制标题
DOI：
10.1186/s12916-021-02115-0
复制
发表时间：
2021-09-27
期刊：
影响因子：
9.3
通讯作者：
Murphy SN
中科院分区：
文献类型：
--
作者：
Estiri H;Strasser ZH;Brat GA;Semenov YR;Consortium for Characterization of COVID-19 by EHR (4CE);Patel CJ;Murphy SN
对于一些SARS-CoV-2幸存者来说，从感染的急性阶段恢复一直很艰难，影响挥之不去。许多被描述为COVID-19急性后后遗症的症状可能有多种原因，或者在未感染COVID-19的患者中也能看到类似的症状。准确识别PASC表型对于指导未来的研究非常重要，并有助于医疗保健系统将精力和资源集中在充分控制的COVID-19感染的年龄和性别特异性后遗症上。在这项回顾性电子健康记录（EHR）队列研究中，我们应用了从临床数据MLHO中发现知识的计算框架，以确定与过去阳性的COVID-19逆转录聚合酶链反应（RT-PCR）检测呈正相关的表型。我们在测试后3-6个月和6-9个月的两个时间窗口中评估测试后表型，并按年龄和性别进行评估。来自波士顿大都会区布里格姆总医院电子病历中纵向诊断记录的数据被用于分析。对2020年3月至2021年6月的数据进行统计分析。研究参与者包括超过9.6万名COVID-19检测呈阳性或阴性且未住院的患者。我们在不同年龄/性别队列或时间窗口中确定了33种表型，这些表型与过去的SARS-CoV-2感染呈正相关。所有鉴定出的表型都是在非住院患者进行COVID-19 RT-PCR检测后2个月或更长时间内新记录在患者病历中，无论检测结果如何。在这些表型中，嗅觉丧失和嗅觉障碍（OR 2.60, 95% CI[1.94-3.46]）、脱发（OR 3.09, 95% CI[2.53-3.76]）、胸痛（OR 1.27, 95% CI[1.09-1.48]）、慢性疲劳综合征（OR 2.60, 95% CI[1.22-2.10]）、呼吸短促（OR 1.41, 95% CI[1.22-1.64]）、肺炎（OR 1.66, 95% CI[1.28-2.16]）和2型糖尿病（OR 1.41, 95% CI[1.22-1.64]）是既往COVID-19感染的最重要指标之一。此外，在65岁以下的人群中，更多的新表型被发现，信心增加。这项研究的结果证实了COVID-19后的许多症状，并表明各种新的诊断，包括新的糖尿病和神经系统疾病的诊断，在有COVID-19病史的人中比没有感染的人更常见。此外，在65岁以下的患者中观察到超过63%的PASC表型，这指出了接种疫苗对于最大限度地减少年轻人COVID-19急性后后遗症的重要性。在线版本包含补充材料，可在10.1186/s12916-021-02115-0获得。
For some SARS-CoV-2 survivors, recovery from the acute phase of the infection has been grueling with lingering effects. Many of the symptoms characterized as the post-acute sequelae of COVID-19 (PASC) could have multiple causes or are similarly seen in non-COVID patients. Accurate identification of PASC phenotypes will be important to guide future research and help the healthcare system focus its efforts and resources on adequately controlled age- and gender-specific sequelae of a COVID-19 infection. In this retrospective electronic health record (EHR) cohort study, we applied a computational framework for knowledge discovery from clinical data, MLHO, to identify phenotypes that positively associate with a past positive reverse transcription-polymerase chain reaction (RT-PCR) test for COVID-19. We evaluated the post-test phenotypes in two temporal windows at 3–6 and 6–9 months after the test and by age and gender. Data from longitudinal diagnosis records stored in EHRs from Mass General Brigham in the Boston Metropolitan Area was used for the analyses. Statistical analyses were performed on data from March 2020 to June 2021. Study participants included over 96 thousand patients who had tested positive or negative for COVID-19 and were not hospitalized. We identified 33 phenotypes among different age/gender cohorts or time windows that were positively associated with past SARS-CoV-2 infection. All identified phenotypes were newly recorded in patients’ medical records 2 months or longer after a COVID-19 RT-PCR test in non-hospitalized patients regardless of the test result. Among these phenotypes, a new diagnosis record for anosmia and dysgeusia (OR 2.60, 95% CI [1.94–3.46]), alopecia (OR 3.09, 95% CI [2.53–3.76]), chest pain (OR 1.27, 95% CI [1.09–1.48]), chronic fatigue syndrome (OR 2.60, 95% CI [1.22–2.10]), shortness of breath (OR 1.41, 95% CI [1.22–1.64]), pneumonia (OR 1.66, 95% CI [1.28–2.16]), and type 2 diabetes mellitus (OR 1.41, 95% CI [1.22–1.64]) is one of the most significant indicators of a past COVID-19 infection. Additionally, more new phenotypes were found with increased confidence among the cohorts who were younger than 65. The findings of this study confirm many of the post-COVID-19 symptoms and suggest that a variety of new diagnoses, including new diabetes mellitus and neurological disorder diagnoses, are more common among those with a history of COVID-19 than those without the infection. Additionally, more than 63% of PASC phenotypes were observed in patients under 65 years of age, pointing out the importance of vaccination to minimize the risk of debilitating post-acute sequelae of COVID-19 among younger adults. The online version contains supplementary material available at 10.1186/s12916-021-02115-0.
登录
查看更多内容
影响因子：
7.7
作者：
Gregorova M;Morse D;Brignoli T;Steventon J;Hamilton F;Albur M;Arnold D;Thomas M;Halliday A;Baum H;Rice C;Avison MB;Davidson AD;Santopaolo M;Oliver E;Goenka A;Finn A;Wooldridge L;Amulic B;Boyton RJ;Altmann DM;Butler DK;McMurray C;Stockton J;Nicholls S;Cooper C;Loman N;Cox MJ;Rivino L;Massey RC
通讯作者：
Massey RC
通过电子病历预测COVID-19死亡率。
影响因子：
15.2
作者：
Estiri H;Strasser ZH;Klann JG;Naseri P;Wagholikar KB;Murphy SN
通讯作者：
Murphy SN
DOI：
10.1146/annurev-genom-090314-024956
发表时间：
2016-08-31
影响因子：
8.7
作者：
Denny JC;Bastarache L;Roden DM
通讯作者：
Roden DM
影响因子：
64.8
作者：
Al-Aly, Ziyad;Xie, Yan;Bowe, Benjamin
通讯作者：
Bowe, Benjamin
DOI：
10.1016/j.jcmg.2020.10.023
发表时间：
2021-03
期刊：
JACC. Cardiovascular imaging
影响因子：
--
作者：
Brito D;Meester S;Yanamala N;Patel HB;Balcik BJ;Casaclang-Verzosa G;Seetharam K;Riveros D;Beto RJ 2nd;Balla S;Monseau AJ;Sengupta PP
通讯作者：
Sengupta PP