Mapping each pre-existing condition's association to short-term and long-term COVID-19 complications.
Mapping each pre-existing condition's association to short-term and long-term COVID-19 complications.
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DOI：
10.1038/s41746-021-00484-7
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发表时间：
2021-07-27
影响因子：
15.2
通讯作者：
Soundararajan V
中科院分区：
文献类型：
--
作者：
Venkatakrishnan AJ;Pawlowski C;Zemmour D;Hughes T;Anand A;Berner G;Kayal N;Puranik A;Conrad I;Bade S;Barve R;Sinha P;O'Horo JC;Badley AD;Halamka J;Soundararajan V
了解先前存在的疾病与COVID-19感染并发症之间的关系对于确定哪些患者将发展为严重疾病至关重要。在这里，我们利用来自1803名住院COVID-19患者的约110万份临床记录和深度神经网络模型来描述21种既存疾病与20种并发症之间的关联（如呼吸系统、心血管系统、肾脏和血液系统）（即0-30天、31-60天和61-90天）。胸腔积液是早期COVID-19感染最常见的并发症（89/1803例患者，4.9%），其次是心律失常（45/1803例患者，2.5%）。值得注意的是，高血压是与包括急性呼吸窘迫综合征、心律失常和贫血在内的10种不同并发症相关的最重要危险因素。30天后发生新并发症的情况很少见，最常见的是胸腔积液（31-60天：11例患者，61-90天：9例患者）。最后，将并发症发生率与倾向匹配的新冠病毒阴性住院人群进行比较，证实了高血压作为早发性并发症危险因素的重要性。总的来说，本文提出的COVID前状况与COVID相关并发症之间的关联可能构成风险评估评分的基础，以指导临床护理路径。
Understanding the relationships between pre-existing conditions and complications of COVID-19 infection is critical to identifying which patients will develop severe disease. Here, we leverage ~1.1 million clinical notes from 1803 hospitalized COVID-19 patients and deep neural network models to characterize associations between 21 pre-existing conditions and the development of 20 complications (e.g. respiratory, cardiovascular, renal, and hematologic) of COVID-19 infection throughout the course of infection (i.e. 0–30 days, 31–60 days, and 61–90 days). Pleural effusion was the most frequent complication of early COVID-19 infection (89/1803 patients, 4.9%) followed by cardiac arrhythmia (45/1803 patients, 2.5%). Notably, hypertension was the most significant risk factor associated with 10 different complications including acute respiratory distress syndrome, cardiac arrhythmia, and anemia. The onset of new complications after 30 days is rare and most commonly involves pleural effusion (31–60 days: 11 patients, 61–90 days: 9 patients). Lastly, comparing the rates of complications with a propensity-matched COVID-negative hospitalized population confirmed the importance of hypertension as a risk factor for early-onset complications. Overall, the associations between pre-COVID conditions and COVID-associated complications presented here may form the basis for the development of risk assessment scores to guide clinical care pathways.
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影响因子：
39
作者：
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通讯作者：
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影响因子：
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作者：
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