However, a worrying subset of 15% of patients presented with lung involvement of moderate severity requiring hospital admission, and 5% with severe respiratory failure and systemic host-immune response resulting in fatality in half of such cases. Numerous studies have highlighted the clinical characteristics of the disease, showing that 80% of COVID-19 patients present a low-mild disease with an overall case mortality rate of 2–3%. As of 6 October 2020, 35 million people have been infected worldwide and 1 million people have died. Since January 2020, the COVID-19 pneumonia pandemic has spread across the globe. (4) Conclusions: The present study identified 4 phenotypic clusters in patients with COVID-19 pneumonia, which predicted the in-hospital prognosis of clinical outcomes. 18.6% p 20 bpm, lower PaO2/FiO2 at admission, higher levels of C-reactive protein (CRP) and lactate dehydrogenase (LDH), and the phenotypic cluster as independent factors for in-hospital death. Compared to each other, cluster C1 presented the highest in-hospital mortality (24.1% vs. Cluster C2 (1196 patients, 9.9%) also presented with ageusia and anosmia cluster C3 (880 patients, 7.3%) also had arthromyalgia, headache, and sore throat and cluster C4 (1253 patients, 10.4%) also manifested with diarrhea, vomiting, and abdominal pain. Cluster C1 (8737 patients, 72.4%) was the largest, and comprised patients with the triad alone. The triad of fever, cough, and dyspnea was present almost uniformly in all 4 clinical phenotypes identified by clustering. The average number of days from COVID-19 symptom onset to hospital admission was 6.7 (SD 7). The main pre-admission comorbidities were arterial hypertension (6030, 50%), hyperlipidemia (4741, 39.4%) and diabetes mellitus (2309, 19.2%). (3) Results: Of the total of 12,066 patients included in the study, most were males (7052, 58.5%) and Caucasian (10,635, 89.5%), with a mean age at diagnosis of 67 years (standard deviation (SD) 16). (2) Methods: Cluster analysis including 11 phenotypic variables was performed in a large cohort of 12,066 COVID-19 patients, collected and followed-up from 1 March to 31 July 2020, from the nationwide Spanish Society of Internal Medicine (SEMI)-COVID-19 Registry.
This study aims to identify different clinical phenotypes in COVID-19 pneumonia using cluster analysis and to assess the prognostic impact among identified clusters in such patients. (1) Background: Different clinical presentations in COVID-19 are described to date, from mild to severe cases.
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