International Journal of Infectious Diseases (Jul 2024)
Temporal patterns of organ dysfunction in COVID-19 patients hospitalized in the intensive care unit: A group-based multitrajectory modeling analysis
- Jiafei Yu,
- Kai Zhang,
- Tianqi Chen,
- Ronghai Lin,
- Qijiang Chen,
- Chensong Chen,
- Minfeng Tong,
- Jianping Chen,
- Jianhua Yu,
- Yuhang Lou,
- Panpan Xu,
- Chao Zhong,
- Qianfeng Chen,
- Kangwei Sun,
- Liyuan Liu,
- Lanxin Cao,
- Cheng Zheng,
- Ping Wang,
- Qitao Chen,
- Qianqian Yang,
- Weiting Chen,
- Xiaofang Wang,
- Zuxi Yan,
- Xuefeng Zhang,
- Wei Cui,
- Lin Chen,
- Zhongheng Zhang,
- Gensheng Zhang
Affiliations
- Jiafei Yu
- Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China; Department of Critical Care Medicine, Haiyan People's Hospital, Zhejiang 314300, China
- Kai Zhang
- Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Tianqi Chen
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China
- Ronghai Lin
- Department of Critical Care Medicine, Taizhou Municipal Hospital, Zhejiang, 318000, China
- Qijiang Chen
- Intensive Care Unit, Ninghai First Hospital, Zhejiang, 315600, China
- Chensong Chen
- Intensive Care Unit, Xiangshan First People's Hospital Medical and Health Group, Zhejiang, 315700, China
- Minfeng Tong
- Department of Neurosurgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Zhejiang, 321000, China
- Jianping Chen
- Department of Emergency Medicine, Dongyang People' Hospital of Wenzhou Medical University, Zhejiang, 322100, China
- Jianhua Yu
- Department of Critical Care Medicine, Longquan People's Hospital, Zhejiang, 323700, China
- Yuhang Lou
- Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Panpan Xu
- Department of Critical Care Medicine, Taizhou Municipal Hospital, Zhejiang, 318000, China
- Chao Zhong
- Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China; Intensive Care Unit, Ninghai First Hospital, Zhejiang, 315600, China
- Qianfeng Chen
- Intensive Care Unit, Xiangshan First People's Hospital Medical and Health Group, Zhejiang, 315700, China
- Kangwei Sun
- Department of Emergency Medicine, Dongyang People' Hospital of Wenzhou Medical University, Zhejiang, 322100, China
- Liyuan Liu
- Department of Critical Care Medicine, Longquan People's Hospital, Zhejiang, 323700, China
- Lanxin Cao
- Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Cheng Zheng
- Department of Critical Care Medicine, Taizhou Municipal Hospital, Zhejiang, 318000, China
- Ping Wang
- Intensive Care Unit, Ninghai First Hospital, Zhejiang, 315600, China
- Qitao Chen
- Department of Neurosurgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Zhejiang, 321000, China
- Qianqian Yang
- Department of Neurosurgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Zhejiang, 321000, China
- Weiting Chen
- Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China; Department of Emergency and Intensive Care Unit, The First People's Hospital of Linhai, Taizhou, Zhejiang 317000, China
- Xiaofang Wang
- Department of Cardiovascular Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Zuxi Yan
- Department of Critical Care Medicine, Haiyan People's Hospital, Zhejiang 314300, China
- Xuefeng Zhang
- Department of Critical Care Medicine, Second Affiliated Hospital, Jiaxing College School of Medicine, Jiaxing 314031, China
- Wei Cui
- Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Lin Chen
- Department of Neurosurgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Zhejiang, 321000, China
- Zhongheng Zhang
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China
- Gensheng Zhang
- Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China; Key Laboratory of Multiple Organ Failure (Zhejiang University), Ministry of Education, Hangzhou 310009, China; Corresponding author. Gensheng Zhang, Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine; Key Laboratory of Multiple Organ Failure (Zhejiang University), Ministry of Education, Hangzhou 310009, China.
- Journal volume & issue
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Vol. 144
p. 107045
Abstract
Background: The course of organ dysfunction (OD) in Corona Virus Disease 2019 (COVID-19) patients is unknown. Herein, we analyze the temporal patterns of OD in intensive care unit-admitted COVID-19 patients. Methods: Sequential organ failure assessment scores were evaluated daily within 2 weeks of admission to determine the temporal trajectory of OD using group-based multitrajectory modeling (GBMTM). Results: A total of 392 patients were enrolled with a 28-day mortality rate of 53.6%. GBMTM identified four distinct trajectories. Group 1 (mild OD, n = 64), with a median APACHE II score of 13 (IQR 9-21), had an early resolution of OD and a low mortality rate. Group 2 (moderate OD, n = 140), with a median APACHE II score of 18 (IQR 13-22), had a 28-day mortality rate of 30.0%. Group 3 (severe OD, n = 117), with a median APACHR II score of 20 (IQR 13-27), had a deterioration trend of respiratory dysfunction and a 28-day mortality rate of 69.2%. Group 4 (extremely severe OD, n = 71), with a median APACHE II score of 20 (IQR 17-27), had a significant and sustained OD affecting all organ systems and a 28-day mortality rate of 97.2%. Conclusions: Four distinct trajectories of OD were identified, and respiratory dysfunction trajectory could predict nonpulmonary OD trajectories and patient prognosis.
