三个住院的非危急的COVID-19亚现型以及随时间的推移而发生的输管或死亡的变化:具有外部和纵向验证的潜在类分析
William S Stringer1, Amy S Labar2, Joshua D Geleris1
1Division of Pulmonary, Allergy, and Critical Care, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States of America.
PloS one
|March 19, 2025
概括
研究人员在住院患者中确定了三种不同的COVID-19亚型,在病毒变异中持续存在. 中级炎症组在标准治疗中表现出更好的结果,有助于临床试验分析.
科学领域:
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
- 计算生物学 计算生物学
背景情况:
- COVID-19急性呼吸困扰综合征 (ARDS) 已知具有多种类型的皮质类固醇反应的亚型.
- 目前尚不清楚在非危急的住院COVID-19患者中是否存在类似的亚型.
研究的目的:
- 在入院时识别和验证非危急COVID-19患者的不同亚型.
- 为了阐明COVID-19的病理生物学,并促进临床试验中的治疗效果分析.
主要方法:
- 住院非危急COVID-19患者的多中心回顾性队列研究.
- 在野生型和三角形SARS-CoV2波浪期间使用临床和实验室数据进行潜在类别分析.
- XGBoost机器学习模型被训练来预测子类型.
主要成果:
- 对4827名患者的分析揭示了三个持续的亚型:低炎症,中等炎症和高炎症.
- 在野生类型的波浪中,插管或死亡的风险在各个亚现象类型中增加.
- 在三角波中,中间炎症亚表型表现出最低的风险;XGBoost模型实现了0.96 AUC.
结论:
- 确定了三种住院的非危急的COVID-19亚现型,它们在SARS-CoV2波浪中持续存在.
- 中级炎症亚表型在标准化治疗中表现出更好的输管和生存率.
- 开发了一种机器学习模型,以帮助在临床试验中对住院的非危急COVID-19患者进行治疗异质效应分析.
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