Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia in Critically Ill Patients: A Cluster Analysis According to Baseline Characteristics, Biological Features, and Chest CT Scan on Admission

Grapin, K; De Bauchene, R; Bonnet, B; Mirand, A; Cassagnes, L; Calvet, L; Thouy, F; Bouzgarrou, R; Henquell, C; Evrard, B; Adda, M; Souweine, B; Dupuis, C

doi:10.1097/ccm.0000000000006105

Sepsis & infection

Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia in Critically Ill Patients: A Cluster Analysis According to Baseline Characteristics, Biological Features, and Chest CT Scan on Admission

Crit Care MedPublished 27 Oct 2023Retrospective cohort study

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Authors' conclusion

Three clusters with distinct characteristics and outcomes were identified.

Study context

Population: Consecutive adults (≥18 years) admitted to a medical ICU in Clermont-Ferrand, France, for COVID-19 pneumonia, March 2020–August 20214 clusters, 3 fully described
Participants: 270 adults

Exposure: Clusters defined by admission characteristics
Outcome: Day 60 mortality by cluster
Follow-up: Day 60

Methodological detailssingle-centre, cluster analysis (hierarchical clustering on principal components)

Single-centre
Cluster analysis (hierarchical clustering on principal components)

Main finding

As reported in the abstract

Hazard ratio (CI)P value

Cluster 1

0.27(0.15–0.46)

P < 0.01

Cluster 2

2.07(1.37–3.13)

P < 0.01

Cluster 3

1.52(1–2.32)

P = 0.05

Observational data: associations, not effects.

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Reference

Authors: Grapin K, De Bauchene R, Bonnet B, Mirand A, Cassagnes L, Calvet L, et al.
All 13 authors
Grapin K, De Bauchene R, Bonnet B, Mirand A, Cassagnes L, Calvet L, Thouy F, Bouzgarrou R, Henquell C, Evrard B, Adda M, Souweine B, Dupuis C
Journal: Critical Care Medicine
Published: 27 Oct 2023
DOI: 10.1097/ccm.0000000000006105
PubMed: 37889095

Topic: Sepsis & infection

Exposure

Clusters defined by admission characteristics (incl. IL-6, mHLA-DR, extent of lung lesions on CT)

Exposure definitions

Cluster 1: obese patients, moderate hypoxemia, moderate extent of lung parenchymal lesions, no inflammation, no down-regulation of mHLA-DR
Cluster 2: older patients with comorbidities, moderate extent of lung parenchyma lesions but significant hypoxemia, inflammation, down-regulation of mHLA-DR
Cluster 3: severe parenchymal disease, hypoxemia, inflammatory reaction, down-regulation of mHLA-DR

Key notes

In multivariate analysis, only clusters 1 and 2 independently associated with day 60 death
Univariate survival analysis

Original publication

Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia in Critically Ill Patients: A Cluster Analysis According to Baseline Characteristics, Biological Features, and Chest CT Scan on Admission. Crit Care Med. Published 27 October 2023. doi:10.1097/ccm.0000000000006105

Read the original article ↗

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