Researchers create prototypes for severe COVID-19 infection

Attending physicians take care of an older man in a hospital who is recovering from COVID-19.

In a study of 7,358 adults who tested positive for COVID-19 at one of 14 Midwestern hospitals and 60 medical centers in Minnesota,1,022 received hospital care. Among hospitalized patients, three distinctions emerged to characterize adverse, moderate, and favorable COVID-19 outcomes.

The first group of hospitalized patients, the "adverse group," were more likely to be older, require intensive care, and experience severe outcomes, including death. These patients were also more likely to have systemic inflammation, a sign of the body fighting off infection or illness, and underlying blood, renal, and cardiac conditions. Patients in this group were more likely to be non-white and non-English speaking. Most patients fell into the second group and had a moderate course of illness, but were more likely than participants in the third group to require intensive care or assisted breathing support. Patients in the third category or "favorable group" had the best outcomes, but were more likely to return to the hospital. These patients were more likely to be women and have underlying respiratory conditions, including asthma or chronic obstructive pulmonary disease. The authors note more research is necessary to study how underlying factors, ranging from genetic susceptibility to using anti-inflammatory asthma medications, may influence clinical outcomes for COVID-19. Among patients in the three groups, there were no significant differences for cardiovascular complications, body weight, or socioeconomic status.

The authors envision these models may help physicians personalize treatment for COVID-19, such as using blood thinners or immunomodulators for patients with severe infection. The study published in PLoS One and was supported by the NHLBI.