COVID-19 patients can be categorised into three groups, say scientists
Washington: Scientists have identified three different types of COVID-19 disease traits in patients, depending on their comorbidities, complications, and clinical outcomes, an advance that may help target future interventions to the most risk-prone individuals.
The new study, published in the journal PLOS ONE, analysed the electronic health records (EHRs) from 14 hospitals in the midwestern US and from 60 primary care clinics in the state of Minnesota.
According to the researchers, including those from the University of Minnesota in the US, the study included 7,538 patients with confirmed COVID-19 between March 7 and August 25, 2020, of which 1,022 patients required hospitalisation.
Close to 60 per cent of the patients included in the research presented with what the researchers called "phenotype II."
They said about 23 per cent of the patients presented with "phenotype I," or the "adverse phenotype," which was associated with the worst clinical outcomes.
The researchers said these patients had the highest level of comorbidies related to heart and kidney dysfunction.
According to the study, 173 patients, or 16.9 per cent presented with "phenotype III," or the "favorable phenotype," which the scientists said was associated with the best clinical outcomes.
While this group had the lowest complication rate and mortality, the scientists said these patients had the highest rate of respiratory comorbidities as well as a 10 per cent greater risk of hospital readmission compared to the other phenotypes.
Overall, they said phenotypes I and II were associated with 7.30-fold and 2.57-fold increases in hazard of death relative to phenotype III.
Based on the results, the scientists said such phenotype-specific medical care could improve COVID-19 outcomes.
However, they believe further studies are needed to determine the utility of these findings in clinical practice.
"Patients do not suffer from COVID-19 in a uniform matter. By identifying similarly affected groups, we not only improve our understanding of the disease process, but this enables us to precisely target future interventions to the highest risk patients," the scientists added.
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England sticking with Key, McCullum and Stokes despite Ashes humbling
London (AP): England is not sacking anybody following the 4-1 Ashes loss in Australia.
A review of the tour by the England and Wales Cricket Board, announced within hours of the final match in January, was concluded on Monday. Firing people would “be the easy thing to do,” ECB chief executive Richard Gould said but he insisted, "This is not the time to throw everything out."
Managing director Rob Key, coach Brendon McCullum and captain Ben Stokes kept their jobs after the best England side to go to Australia in 14 years lost the Ashes in 11 days with two games to spare.
“Moving people on can sometimes be the easy thing to do. That's not the route that we're going to take,” Gould said. “I've seen the driving ambition and determination that we're lucky enough to have within our leadership group to take the lessons from the Ashes and move forward.”
Gould previously was the chief executive of Bristol City soccer club and said the ECB would not follow the same route as soccer's hire-and-fire culture.
“Cricket is a very unique sport in that it takes a team of leadership ... it's not like football where there's a single point of failure or success with a manager," he said. He added the ECB would not “select or deselect management based on a popularity campaign.”
The main criticisms of England's tour were poor preparation, player misbehavior, and selection mistakes.
At a press conference at Lord's, Gould and Key said McCullum and Stokes have not had a “bust up,” they did not want McCullum to “completely change” but “to evolve,” the behavior of some players was “unprofessional,” there will be more consequences for underperforming, and a commitment to “better long-term planning” ahead of major test series.
Some changes were already implemented for the Twenty20 World Cup, where England reached the semifinals. Gould implied that performance saved McCullum.
Key acknowledged that England supporters would be disappointed to see the management team go unpunished.
“I know people want punishment and that people then should be sacked for that,” Key said. “That doesn't mean we don't feel like we've gone through some serious pain: Brendon, myself, Ben. It's been as tough a time as I think I've had.”
