Modeling clinical trajectory status of critically ill COVID-19 patients over time: A method for analyzing discrete longitudinal and ordinal outcomes.

Early in the COVID-19 pandemic, the World Health Organization stressed the importance of daily clinical assessments of infected patients, yet current approaches frequently consider cross-sectional timepoints, cumulative summary measures, or time-to-event analyses. Statistical methods are available that make use of the rich information content of longitudinal assessments. We demonstrate the use of a multistate transition model to assess the dynamic nature of COVID-19-associated critical illness using daily evaluations of COVID-19 patients from 9 academic hospitals. We describe the accessibility and utility of methods that consider the clinical trajectory of critically ill COVID-19 patients.

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© The Author(s) 2022.

Déclaration de conflit d'intérêts

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Dr Ginde reports grants from CDC, during the conduct of the study; grants from NIH, grants from Department of Defense, grants from AbbVie, grants from Faron Pharmaceuticals, outside the submitted work. Matthew C. Exline reports talks on nutrition in COVID pneumonia at APEN conference sponsored by Abbott Labs. Akram Khan reports grants from United Therapeutics, Johnson & Johnson, 4D Medical, Lung LLC, and Reata Pharmaceuticals. D. Clark Files reports consultant fees from Cytovale and membership on a Medpace Data Safety Monitoring Board (DSMB). Dr Rice reports grants from Centers for Disease Control (CDC), during the conduct of the study; personal fees from Cumberland Pharmaceuticals, Inc., personal fees from Cytovale, Inc., personal fees from Sanofi, Inc., outside the submitted work. Jonathan D. Casey reports a grant (N23HL153584) from the National Institutes of Health (NIH). Daniel J. Henning reports consulting fees from Cytovale and Opticyte. Samuel M. Brown reports fees from Hamilton for chairing a DSMB, and institutional fees from Faron, Sedana, and Janssen; grants from Sedana, Janssen, NIH, and the Department of Defense (DoD); book royalties from Oxford University and Brigham Young University; and personal fees from New York University for service on a DSMB. Wesley H. Self reports grant funding from CDC for this work; grants and consultant fees from Merck outside this work and consultant fees from Aerpio Pharmaceuticals outside this work. Christopher J. Lindsell reports grants from NIH, DoD, and the Marcus Foundation; organizational contract fees from bioMerieux, Endpoint LLC, and Entegrion, Inc.; and a patent issued to Cincinnati Children’s Hospital Medical Center for risk stratification in sepsis and septic shock. No other potential conflicts of interest were disclosed.