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使用床边生命体征的轨迹来识别COVID-19亚现型
Sivasubramanium V Bhavani1, Chad Robichaux2, Philip A Verhoef3
1Department of Medicine, Emory University, Atlanta, GA; Emory Critical Care Center, Atlanta, GA.
Chest
|September 25, 2023
概括
床边生命体征轨迹确定了四种COVID-19亚表型,具有不同的结果. 住院患者的这些发现可以指导针对性治疗,以更好地管理患者.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 在医疗保健中的数据科学.
背景情况:
- 生命体征轨迹是已确立的败血症亚型类型的预测因素.
- 在COVID-19患者中验证这些模型对于理解疾病异质性至关重要.
研究的目的:
- 在多中心COVID-19队列中验证一个生命体征轨迹模型.
- 描述已识别的COVID-19亚现型的临床特征和结果.
主要方法:
- 从入院的最初8小时开始,利用基于群体的生命体征 (温度,心率,血压,呼吸率) 的轨迹模型.
- 包括7065名成年患者在四所学术医院接受COVID-19治疗.
- 将亚表型之间的临床特征,生物标志物和结果进行比较,并评估托西利祖马布治疗效果的异质性.
主要成果:
- 确定了四种COVID-19亚型:A (高生命体,低血压),B (高生命体,高血压),C (低生命体,正常血压) 和D (低生命体,低血压).
- 亚现象类型A和D显示机械通风,血管压缩剂和30天死亡率的几率明显更高.
- 托西利祖马布治疗在30天死亡率的影响上表现出显著的异质性.
结论:
- 常规的临床生命体征可以识别不同的COVID-19亚型,即使在资源有限的环境中.
- 这些子类型与各种临床表现和预后有关.
- 这些发现支持开发COVID-19的预防性和向性治疗策略.
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