Phenome-wide association of 1809 phenotypes and COVID-19 disease progression in the Veterans Health Administration Million Veteran Program.
Phenome-wide association of 1809 phenotypes and COVID-19 disease progression in the Veterans Health Administration Million Veteran Program.
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DOI：
10.1371/journal.pone.0251651
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
VA Million Veteran Program COVID-19 Science Initiative
中科院分区：
文献类型：
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作者：
Song RJ;Ho YL;Schubert P;Park Y;Posner D;Lord EM;Costa L;Gerlovin H;Kurgansky KE;Anglin-Foote T;DuVall S;Huffman JE;Pyarajan S;Beckham JC;Chang KM;Liao KP;Djousse L;Gagnon DR;Whitbourne SB;Ramoni R;Muralidhar S;Tsao PS;O'Donnell CJ;Gaziano JM;Casas JP;Cho K;VA Million Veteran Program COVID-19 Science Initiative
与2019冠状病毒病（COVID-19）疾病进展阶段相关的风险因素尚不清楚。我们的目标是确定从SARS-CoV-2感染到死亡的COVID-19进展的每种状态的特定风险因素。我们包括来自退伍军人事务百万退伍军人计划（2011年-）的648，202名参与者。我们从电子健康记录中确定了1，809个基于ICD代码的表型。我们使用logistic回归分析了年龄、性别、体重指数（BMI）、种族和流行表型与COVID-19疾病进展阶段（感染、住院、重症监护室（ICU）入院和30天死亡率）的相关性（每个阶段的模型不同）。根据年龄、性别、人种、种族、访视月数和ICD代码、状态感染率调整模型，并使用错误发现率（≤0.1）控制多重检验。截至2020年8月10日，5，929人为SARS-CoV-2阳性，其中1，463人（25%）住院，579人（10%）在ICU，398人（7%）死亡。我们观察到女性ICU和死亡率的风险低于男性（比值比（95% CI）：0.48（0.30-0.76）和0.59（分别为0.31-1.15）），黑人患者住院和ICU的风险高于其他种族患者（OR（95%CI）分别为1.53（1.32-1.77）和1.63（1.32-2.02））。我们观察到年龄较大和BMI ≥35与20-24 kg/m2相比，所有COVID-19疾病状态的风险增加。肾衰竭、呼吸衰竭、病态肥胖、酸碱平衡紊乱、白色血细胞疾病、肾积水和细菌感染与ICU入院风险增加相关;败血症、慢性皮肤溃疡、酸碱平衡紊乱和酸中毒与死亡率相关。年龄较大、BMI较高、男性和有呼吸系统、肾脏、细菌或代谢合并症病史的患者经历了更严重的COVID-19。未来的研究将探讨与这些表型簇和COVID-19相关的潜在机制。
The risk factors associated with the stages of Coronavirus Disease-2019 (COVID-19) disease progression are not well known. We aim to identify risk factors specific to each state of COVID-19 progression from SARS-CoV-2 infection through death. We included 648,202 participants from the Veteran Affairs Million Veteran Program (2011-). We identified characteristics and 1,809 ICD code-based phenotypes from the electronic health record. We used logistic regression to examine the association of age, sex, body mass index (BMI), race, and prevalent phenotypes to the stages of COVID-19 disease progression: infection, hospitalization, intensive care unit (ICU) admission, and 30-day mortality (separate models for each). Models were adjusted for age, sex, race, ethnicity, number of visit months and ICD codes, state infection rate and controlled for multiple testing using false discovery rate (≤0.1). As of August 10, 2020, 5,929 individuals were SARS-CoV-2 positive and among those, 1,463 (25%) were hospitalized, 579 (10%) were in ICU, and 398 (7%) died. We observed a lower risk in women vs. men for ICU and mortality (Odds Ratio (95% CI): 0.48 (0.30–0.76) and 0.59 (0.31–1.15), respectively) and a higher risk in Black vs. Other race patients for hospitalization and ICU (OR (95%CI): 1.53 (1.32–1.77) and 1.63 (1.32–2.02), respectively). We observed an increased risk of all COVID-19 disease states with older age and BMI ≥35 vs. 20–24 kg/m2. Renal failure, respiratory failure, morbid obesity, acid-base balance disorder, white blood cell diseases, hydronephrosis and bacterial infections were associated with an increased risk of ICU admissions; sepsis, chronic skin ulcers, acid-base balance disorder and acidosis were associated with mortality. Older age, higher BMI, males and patients with a history of respiratory, kidney, bacterial or metabolic comorbidities experienced greater COVID-19 severity. Future studies to investigate the underlying mechanisms associated with these phenotype clusters and COVID-19 are warranted.
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DOI：
10.15585/mmwr.mm6915e3
发表时间：
2020-04-17
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Garg S;Kim L;Whitaker M;O'Halloran A;Cummings C;Holstein R;Prill M;Chai SJ;Kirley PD;Alden NB;Kawasaki B;Yousey-Hindes K;Niccolai L;Anderson EJ;Openo KP;Weigel A;Monroe ML;Ryan P;Henderson J;Kim S;Como-Sabetti K;Lynfield R;Sosin D;Torres S;Muse A;Bennett NM;Billing L;Sutton M;West N;Schaffner W;Talbot HK;Aquino C;George A;Budd A;Brammer L;Langley G;Hall AJ;Fry A
通讯作者：
Fry A
影响因子：
82.9
作者：
Klarin, Derek;Lynch, Julie;Damrauer, Scott M.
通讯作者：
Damrauer, Scott M.
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
影响因子：
15.8
作者：
Harrison, Stephanie L.;Fazio-Eynullayeva, Elnara;Lip, Gregory Y. H.
通讯作者：
Lip, Gregory Y. H.
影响因子：
--
作者：
Bush, K;Kivlahan, DR;Bradley, KA
通讯作者：
Bradley, KA