ArticleIntensive care medicine2024
Clinical phenotyping uncovers heterogeneous associations between corticosteroid treatment and survival in critically ill COVID-19 patients.
Article in Intensive care medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Clinical Practice Guideline: Mechanical Ventilation and Extracorporeal Membrane Oxygenation in Acute Respiratory Insufficiency.Deutsches Arzteblatt international · 2026Guideline
- The Acute Respiratory Distress Syndrome (ARDS): epidemiology, etiology, molecular mechanisms, diagnosis and therapeutic strategies.Molecular biomedicine · 2026Review
- Machine learning-based precision subtyping and risk prediction in sepsis: a retrospective analysis using MIMIC-IV database.BMC infectious diseases · 2026Article
- Prospective multicentre study of upper respiratory mucosal transcriptomics reveals two major endotypes of critically ill COVID-19 patients.Communications medicine · 2026Article
- Corticosteroids in severe community-acquired pneumonia: friend, foe or both?Pneumonia (Nathan Qld.) · 2026Review
- The role of corticosteroids in severe viral pneumonia: lessons from COVID-19 and influenza.Pneumonia (Nathan Qld.) · 2026Review
- Deep Biological Clocks in Critical Care Medicine: A Scoping Review Toward Translational Precision Care.Journal of personalized medicine · 2026Review
- Clinical Phenotypes of Critically Ill Patients with COVID-19 Infected with Omicron: A Nationwide Prospective Cohort Study.Infectious diseases and therapy · 2026Article
- Large-scale proteomic profiling identifies distinct inflammatory phenotypes in acute respiratory distress syndrome: a multicentre, prospective cohort study.The European respiratory journal · 2026Article
- The immunology of sepsis: translating new insights into clinical practice.Nature reviews. Nephrology · 2026Review
- Clinical subphenotypes and molecular endotypes in sepsis: toward an integrated and dynamic framework.Annals of intensive care · 2026Review
- Temporal stability of phenotypes of acute respiratory distress syndrome: clinical implications for early corticosteroid therapy and mortality.Intensive care medicine · 2025Article
- Predictive model for inhaled corticosteroid response in hospitalized asthma: implications for precision medicine.Journal of thoracic disease · 2025Article
- The 15th Anniversary ofLife (Basel, Switzerland) · 2025Review
- Identifying distinct clusters of ICU survivors by integrating demographic, pre-admission quality of life, and clinical data: a large prospective cohort study.Intensive care medicine · 2025Article
- Corticosteroids in immunocompromised ICU patients with severe COVID-19: a multicenter retrospective study.Scientific reports · 2025Article
- Identification and validation of robust hospital-acquired pneumonia subphenotypes associated with all-cause mortality: a multi-cohort derivation and validation.Intensive care medicine · 2025Article
- Identification of Three Distinct Subgroups in Antiphospholipid Syndrome: Implication for Sex Differences and Prognostic Outcomes from a Multicenter Study.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Sepsis subphenotypes, theragnostics and personalized sepsis care.Intensive care medicine · 2025Review
- Observational
Corrections and comments
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Authors and funding
20 authors.
Funding
Abstract
purposeDisease heterogeneity in coronavirus disease 2019 (COVID-19) may render the current one-size-fits-all treatment approach suboptimal. We aimed to identify and immunologically characterize clinical phenotypes among critically ill COVID-19 patients, and to assess heterogeneity of corticosteroid treatment effect.
methodsWe applied consensus k-means clustering on 21 clinical parameters obtained within 24 h after admission to the intensive care unit (ICU) from 13,279 COVID-19 patients admitted to 82 Dutch ICUs from February 2020 to February 2022. Derived phenotypes were reproduced in 6225 COVID-19 ICU patients from Spain (February 2020 to December 2021). Longitudinal immunological characterization was performed in three COVID-19 ICU cohorts from the Netherlands and Germany, and associations between corticosteroid treatment and survival were assessed across phenotypes.
resultsWe derived three phenotypes: COVIDICU1 (43% of patients) consisted of younger patients with the lowest Acute Physiology And Chronic Health Evaluation (APACHE) scores, highest body mass index (BMI), lowest PaO
conclusionOur multinational study identified three distinct clinical COVID-19 phenotypes, each exhibiting marked differences in demographic, clinical, and immunological features, and in the response to late and short-term corticosteroid treatment.
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