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Ho M, Levy TJ, Koulas I, Founta K, Coppa K, Hirsch JS, Davidson KW, Spyropoulos AC, Zanos TP. Longitudinal dynamic clinical phenotypes of in-hospital COVID-19 patients across three dominant virus variants in New York. Int J Med Inform 2024; 181:105286. [PMID: 37956643 PMCID: PMC10843635 DOI: 10.1016/j.ijmedinf.2023.105286] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/20/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND COVID-19 is a challenging disease to characterize given its wide-ranging heterogeneous symptomatology. Several studies have attempted to extract clinical phenotypes but often relied on data from small patient cohorts, usually limited to only one viral variant and utilizing a static snapshot of patient data. OBJECTIVE This study aimed to identify clinical phenotypes of hospitalized COVID-19 patients and investigate their longitudinal dynamics throughout the pandemic, with the goal to relate these phenotypes to clinical outcomes and treatment strategies. METHODS We utilized routinely collected demographic and clinical data throughout the hospitalization of 38,077 patients admitted between 3/2020 to 5/2022, in 12 New York hospitals. Uniform Manifold Approximation and Projection and agglomerative hierarchical clustering were used to derive the clusters, followed by exploratory data analysis to compare the prevalence of comorbidities and treatments per cluster. RESULTS 4 distinct clinical phenotypes remained robust in multi-site validation and were associated with different mortality rates. The temporal progression of these phenotypes throughout the COVID-19 pandemic demonstrated increased variability across the waves of the three dominant viral variants (alpha, delta, omicron). Longitudinal analysis evaluating changes in clinical phenotypes of each patient throughout the course of a 4-week hospital stay exemplified the dynamic nature of the disease progression. Factors such as sex, race/ethnicity and specific treatment modalities revealed significant and clinically relevant differences between the observed phenotypes. CONCLUSIONS Our proposed methodology has the potential of enabling clinicians and policy makers to draw evidence-based conclusions for guiding treatment modalities in a dynamic fashion.
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Affiliation(s)
- Matthew Ho
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY 11549
| | - Todd J Levy
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030
| | - Ioannis Koulas
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030
| | - Kyriaki Founta
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY 11549
| | - Kevin Coppa
- Department of Clinical Digital Solutions, Northwell Health, New Hyde Park, NY 11042
| | - Jamie S Hirsch
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY 11549; Department of Clinical Digital Solutions, Northwell Health, New Hyde Park, NY 11042
| | - Karina W Davidson
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY 11549
| | - Alex C Spyropoulos
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY 11549
| | - Theodoros P Zanos
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY 11549.
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Mahmoodpoor A, Sanaie S, Samadi P, Yousefi M, Nader ND. SARS-CoV-2: Unique Challenges of the Virus and Vaccines. Immunol Invest 2021; 50:802-809. [PMID: 34109900 PMCID: PMC8204310 DOI: 10.1080/08820139.2021.1936009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In November 2019, the highly infectious coronavirus SARS-CoV-2 emerged in Wuhan, China, and has since spread to almost all countries worldwide. Since its emergence, the COVID-19 infection has led to significant public health, economic and social problems. The current pandemic has inspired researchers to make every effort to design and develop an effective COVID-19 vaccine to provide sufficient protection against the virus and control the infection. In December 2020, the Pfizer vaccine was the first COVID-19 vaccine given Emergency Use Authorization (EUA), and the second FDA so-approved vaccine was the Moderna mRNA-1273 vaccine, which was introduced a week later. Both Pfizer and Moderna vaccines are mRNA-based vaccines, and are estimated to have an efficacy rate of more than 94%. The aim of this article is to provide a review of the attempts made to develop safe SARS-CoV-2 vaccines, highlighting potential challenges and concerns, such as disease enhancement, virus mutations, and public acceptance of the vaccine.
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Affiliation(s)
- Ata Mahmoodpoor
- Department of Anesthesiology and Critical Care Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sarvin Sanaie
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parisa Samadi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Yousefi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nader D Nader
- Department of Anesthesiology and Surgery, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
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Alwani M, Yassin A, Al-Zoubi RM, Aboumarzouk OM, Nettleship J, Kelly D, Al-Qudimat AR, Shabsigh R. Sex-based differences in severity and mortality in COVID-19. Rev Med Virol 2021; 31:e2223. [PMID: 33646622 PMCID: PMC8014761 DOI: 10.1002/rmv.2223] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 01/08/2023]
Abstract
The current coronavirus disease (COVID‐19) pandemic caused by novel severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has a male bias in severity and mortality. This is consistent with previous coronavirus pandemics such as SARS‐CoV and MERS‐CoV, and viral infections in general. Here, we discuss the sex‐disaggregated epidemiological data for COVID‐19 and highlight underlying differences that may explain the sexual dimorphism to help inform risk stratification strategies and therapeutic options.
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Affiliation(s)
- Mustafa Alwani
- Surgical Research Section, Hamad Medical Corporation, Doha, Qatar.,Jordan University of Science and Technology, School of Medicine, Irbid, Jordan
| | - Aksam Yassin
- Surgical Research Section, Hamad Medical Corporation, Doha, Qatar.,Department of Surgery, Hamad Medical Corporation, Division of Urology/Andrology & Men's Health, Doha, Qatar.,Center of Medicine and Health Sciences, Dresden International University, Dresden, Germany
| | - Raed M Al-Zoubi
- Surgical Research Section, Hamad Medical Corporation, Doha, Qatar.,Department of Chemistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar M Aboumarzouk
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar.,College of Medicine, Qatar University, Doha, Qatar.,College of Medicine, University of Glasgow, Glasgow, UK
| | - Joanne Nettleship
- Department of Oncology and Metabolism, Medical School, University of Sheffield, Sheffield, UK
| | - Daniel Kelly
- Department of Oncology and Metabolism, Medical School, University of Sheffield, Sheffield, UK.,Biomolecular Research Centre, Sheffield Hallam University, Sheffield, UK
| | | | - Ridwan Shabsigh
- Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York, USA
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