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. 2021 May 19;16(5):e0250569.
doi: 10.1371/journal.pone.0250569. eCollection 2021.

Profiles and outcomes in patients with COVID-19 admitted to wards of a French oncohematological hospital: A clustering approach

Louise Bondeelle  1 , Sylvie Chevret  2   3 , Stéphane Cassonnet  3 , Stéphanie Harel  4 , Blandine Denis  5 , Nathalie de Castro  5 , Anne Bergeron  1   2 ; Saint Louis CORE Team Group
Affiliations

Profiles and outcomes in patients with COVID-19 admitted to wards of a French oncohematological hospital: A clustering approach

Louise Bondeelle et al. PLoS One. .

Abstract

Objectives: Although some prognostic factors for COVID-19 were consistently identified across the studies, differences were found for other factors that could be due to the characteristics of the study populations and the variables incorporated into the statistical model. We aimed to a priori identify specific patient profiles and then assess their association with the outcomes in COVID-19 patients with respiratory symptoms admitted specifically to hospital wards.

Methods: We conducted a retrospective single-center study from February 2020 to April 2020. A non-supervised cluster analysis was first used to detect patient profiles based on characteristics at admission of 220 consecutive patients admitted to our institution. Then, we assessed the prognostic value using Cox regression analyses to predict survival.

Results: Three clusters were identified, with 47 patients in cluster 1, 87 in cluster 2, and 86 in cluster 3; the presentation of the patients differed among the clusters. Cluster 1 mostly included sexagenarian patients with active malignancies who were admitted early after the onset of COVID-19. Cluster 2 included the oldest patients, who were generally overweight and had hypertension and renal insufficiency, while cluster 3 included the youngest patients, who had gastrointestinal symptoms and delayed admission. Sixty-day survival rates were 74.3%, 50.6% and 96.5% in clusters 1, 2, and 3, respectively. This was confirmed by the multivariable Cox analyses that showed the prognostic value of these patterns.

Conclusion: The cluster approach seems appropriate and pragmatic for the early identification of patient profiles that could help physicians segregate patients according to their prognosis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of the study.
Fig 2
Fig 2. Patient profiles at hospital admission.
The left panel shows the dendogram generated using the hierarchical clustering approach. The right panel shows the representation of patients and variables on the first two components of the PCA. COPD: chronic obstructive pulmonary disease, HBP: high blood pressure, Max oxygen: maximum oxygen flow over 24 h of admission, CRP: C-reactive protein, BMI: body mass index; Signs Time: time since disease onset.
Fig 3
Fig 3. Survival since hospital admission, overall (left plot) and according to the clusters (right plot).
See this image and copyright information in PMC

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