Temporal patterns of organ dysfunction in COVID-19 patients hospitalized in the intensive care unit: A group-based multitrajectory modeling analysis

• Published in: International journal of infectious diseases Vol. 144; p. 107045
• Main Authors: Yu, Jiafei, Zhang, Kai, Chen, Tianqi, Lin, Ronghai, Chen, Qijiang, Chen, Chensong, Tong, Minfeng, Chen, Jianping, Yu, Jianhua, Lou, Yuhang, Xu, Panpan, Zhong, Chao, Chen, Qianfeng, Sun, Kangwei, Liu, Liyuan, Cao, Lanxin, Zheng, Cheng, Wang, Ping, Chen, Qitao, Yang, Qianqian, Chen, Weiting, Wang, Xiaofang, Yan, Zuxi, Zhang, Xuefeng, Cui, Wei, Chen, Lin, Zhang, Zhongheng, Zhang, Gensheng
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.07.2024; Elsevier
• Subjects: COVID-19; Group-based multitrajectory modeling; Intensive care unit; Multiple-organ dysfunction; Sequential organ failure assessment score; COVID-19; Sequential organ failure assessment score; Multiple-organ dysfunction; Intensive care unit; Group-based multitrajectory modeling; intensive care unit; multiple-organ dysfunction; group-based multitrajectory modelling; sequential organ failure assessment score
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2024.107045

•Four temporal trajectories of organ dysfunctions were identified by the group-based multitrajectory modeling.•Respiratory dysfunction was the most severe in COVID-19 patients.•Respiratory dysfunction trajectory may predict nonpulmonary organ dysfunctions.•Respiratory dysfunction trajectory may predict patient prognosis. 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. 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). 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%. Four distinct trajectories of OD were identified, and respiratory dysfunction trajectory could predict nonpulmonary OD trajectories and patient prognosis.