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Phenome-wide association of 1809 phenotypes and COVID-19 disease progression in the Veterans Health Administration Million Veteran Program
- Source :
- PLoS ONE, PLoS ONE, Vol 16, Iss 5, p e0251651 (2021)
- Publication Year :
- 2021
-
Abstract
- Background The risk factors associated with the stages of Coronavirus Disease-2019 (COVID-19) disease progression are not well known. We aim to identify risk factors specific to each state of COVID-19 progression from SARS-CoV-2 infection through death. Methods and results We included 648,202 participants from the Veteran Affairs Million Veteran Program (2011-). We identified characteristics and 1,809 ICD code-based phenotypes from the electronic health record. We used logistic regression to examine the association of age, sex, body mass index (BMI), race, and prevalent phenotypes to the stages of COVID-19 disease progression: infection, hospitalization, intensive care unit (ICU) admission, and 30-day mortality (separate models for each). Models were adjusted for age, sex, race, ethnicity, number of visit months and ICD codes, state infection rate and controlled for multiple testing using false discovery rate (≤0.1). As of August 10, 2020, 5,929 individuals were SARS-CoV-2 positive and among those, 1,463 (25%) were hospitalized, 579 (10%) were in ICU, and 398 (7%) died. We observed a lower risk in women vs. men for ICU and mortality (Odds Ratio (95% CI): 0.48 (0.30–0.76) and 0.59 (0.31–1.15), respectively) and a higher risk in Black vs. Other race patients for hospitalization and ICU (OR (95%CI): 1.53 (1.32–1.77) and 1.63 (1.32–2.02), respectively). We observed an increased risk of all COVID-19 disease states with older age and BMI ≥35 vs. 20–24 kg/m2. Renal failure, respiratory failure, morbid obesity, acid-base balance disorder, white blood cell diseases, hydronephrosis and bacterial infections were associated with an increased risk of ICU admissions; sepsis, chronic skin ulcers, acid-base balance disorder and acidosis were associated with mortality. Conclusions Older age, higher BMI, males and patients with a history of respiratory, kidney, bacterial or metabolic comorbidities experienced greater COVID-19 severity. Future studies to investigate the underlying mechanisms associated with these phenotype clusters and COVID-19 are warranted.
- Subjects :
- Male
RNA viruses
Viral Diseases
Pulmonology
Coronaviruses
Epidemiology
Electronic Medical Records
Disease
030204 cardiovascular system & hematology
law.invention
Body Mass Index
0302 clinical medicine
Medical Conditions
Endocrinology
law
Risk Factors
Medicine and Health Sciences
030212 general & internal medicine
Longitudinal Studies
Pathology and laboratory medicine
Veterans
Virus Testing
Aged, 80 and over
Multidisciplinary
Age Factors
Middle Aged
Medical microbiology
Intensive care unit
Hospitals
Type 2 Diabetes
Hospitalization
Intensive Care Units
Infectious Diseases
Viruses
Disease Progression
Medicine
Female
SARS CoV 2
Pathogens
Type 2 Diabetes Risk
Information Technology
Research Article
medicine.medical_specialty
Computer and Information Sciences
SARS coronavirus
Endocrine Disorders
Science
Veterans Health
Lower risk
Microbiology
Sepsis
03 medical and health sciences
Respiratory Disorders
Sex Factors
Diagnostic Medicine
Internal medicine
medicine
Diabetes Mellitus
Humans
Aged
Biology and life sciences
business.industry
SARS-CoV-2
Organisms
Viral pathogens
COVID-19
Covid 19
Health Information Technology
Odds ratio
medicine.disease
United States
Microbial pathogens
Health Care
Respiratory failure
Health Care Facilities
Medical Risk Factors
Metabolic Disorders
Respiratory Infections
business
Body mass index
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 16
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- PloS one
- Accession number :
- edsair.doi.dedup.....321c0534dd280522cbf6c69af21bb304