Clinical Phenotypes of Viral Pneumonia: A Comparative Study Between SARS-CoV-2 and Influenza

The Opportunity

As a result of the pandemic, caused by the novel SARS-CoV-2, the contribution of respiratory viruses to pneumonias is increasingly being recognized and investigated, with an emphasis on therapeutic interventions. The goal of this project was to identify important sub-groups of patients with viral pneumonias, including COVID-19, that may respond differently to targeted therapeutics.

Our Approach

The team set out to discover differences in clinical characteristics between COVID-19 and Influenza A pneumonias. They started by comparing demographics, vital signs, lab values, complications, clinical outcomes, and conducted a multi-state analysis of differences in the clinical course between the two viral pneumonias. Then, they developed predictive models for one virus and that model performed modestly when predicting outcomes in the other.

The Solution

The team discovered that patients with COVID-19-related acute respiratory distress syndrome (ARDS) consistently showed a single respiratory phenotype at the start of invasive mechanical ventilation. Data show there are two distinct trajectories during the first days of invasive mechanical ventilation, with one sub-phenotype showing increasing minute ventilation, mechanical power, and ventilatory ratio. This finding revealed the importance of including time as a key variable in future efforts toward sub-phenotyping COVID-19.