Identification of COVID-19 Clinical Phenotypes by Principal Component Analysis-Based Cluster Analysis.
Identification of COVID-19 Clinical Phenotypes by Principal Component Analysis-Based Cluster Analysis.
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DOI：
10.3389/fmed.2020.570614
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发表时间：
2020
影响因子：
3.9
通讯作者：
Yang L
中科院分区：
文献类型：
--
作者：
Ye W;Lu W;Tang Y;Chen G;Li X;Ji C;Hou M;Zeng G;Lan X;Wang Y;Deng X;Cai Y;Huang H;Yang L
背景：COVID-19迅速蔓延，成为严重的公共卫生威胁。重要的是识别表型以预测疾病的严重程度并设计个体化治疗。方法：我们收集了2020年1月1日至3月30日在武汉市肺科医院就诊的213名COVID-19患者的数据。采用主成分分析和聚类分析对患者进行分类。结果：我们确定了COVID-19的三个不同亚组。聚类1是最大的组（52.6%），其特征是年龄最大、细胞免疫功能和白蛋白水平最低。38.5%的受试者被分组至第2组。聚类2中的大多数实验室结果落在聚类1和聚类3之间。聚类3是最小的聚类（8.9%），其特征在于最年轻的年龄和最高的细胞免疫功能。第1组呼吸衰竭、急性呼吸窘迫综合征（ARDS）、心力衰竭和无创机械通气的发生率明显高于其他组（P < 0.05）。组1的死亡率最高，为30.4%（P = 0.005）。虽然第二组和第三组在年龄上有显著差异（P < 0.001），但我们发现对医疗资源的需求没有差异。结论：我们确定了三个不同的COVID-19患者集群。结果表明，年龄本身不能用来评估病人的病情。具体而言，白蛋白和免疫功能的管理对于降低疾病的严重程度很重要。
Background: COVID-19 has been quickly spreading, making it a serious public health threat. It is important to identify phenotypes to predict the severity of disease and design an individualized treatment. Methods: We collected data from 213 COVID-19 patients in Wuhan Pulmonary Hospital from January 1 to March 30, 2020. Principal component analysis (PCA) and cluster analysis were used to classify patients. Results: We identified three distinct subgroups of COVID-19. Cluster 1 was the largest group (52.6%) and characterized by oldest age, lowest cellular immune function, and albumin levels. 38.5% of subjects were grouped into Cluster 2. Most of the lab results in Cluster 2 fell between those of Clusters 1 and 3. Cluster 3 was the smallest cluster (8.9%), characterized by youngest age and highest cellular immune function. The incidence of respiratory failure, acute respiratory distress syndrome (ARDS), heart failure, and usage of non-invasive mechanical ventilation in Cluster 1 was significantly higher than others (P < 0.05). Cluster 1 had the highest death rate of 30.4% (P = 0.005). Although there were significant differences in age between Clusters 2 and 3 (P < 0.001), we found that there was no difference in demand for medical resources. Conclusions: We identified three distinct clusters of the COVID-19 patients. The results show that age alone could not be used to assess a patient's condition. Specifically, management of albumin, and immune function are important in reducing the severity of disease.