{"doi":"10.1016/j.ebiom.2022.104295","title":"Hospital trajectories and early predictors of clinical outcomes differ between SARS-CoV-2 and influenza pneumonia","abstract":"BACKGROUND: A comparison of pneumonias due to SARS-CoV-2 and influenza, in terms of clinical course and predictors of outcomes, might inform prognosis and resource management. We aimed to compare clinical course and outcome predictors in SARS-CoV-2 and influenza pneumonia using multi-state modelling and supervised machine learning on clinical data among hospitalised patients. METHODS: This multicenter retrospective cohort study of patients hospitalised with SARS-CoV-2 (March-December 2020) or influenza (Jan 2015-March 2020) pneumonia had the composite of hospital mortality and hospice discharge as the primary outcome. Multi-state models compared differences in oxygenation/ventilatory utilisation between pneumonias longitudinally throughout hospitalisation. Differences in predictors of outcome were modelled using supervised machine learning classifiers. FINDINGS: Among 2,529 hospitalisations with SARS-CoV-2 and 2,256 with influenza pneumonia, the primary outcome occurred in 21% and 9%, respectively. Multi-state models differentiated oxygen requirement progression between viruses, with SARS-CoV-2 manifesting rapidly-escalating early hypoxemia. Highly contributory classifier variables for the primary outcome differed substantially between viruses. INTERPRETATION: SARS-CoV-2 and influenza pneumonia differ in presentation, hospital course, and outcome predictors. These pathogen-specific differential responses in viral pneumonias suggest distinct management approaches should be investigated. FUNDING: This project was supported by NIH/NCATS UL1 TR002345, NIH/NCATS KL2 TR002346 (PGL), the Doris Duke Charitable Foundation grant 2015215 (PGL), NIH/NHLBI R35 HL140026 (CSC), and a Big Ideas Award from the BJC HealthCare and Washington University School of Medicine Healthcare Innovation Lab and NIH/NIGMS R35 GM142992 (PS).","journal":"EBioMedicine","year":2022,"id":280505,"datarank":0.3596842909197557,"base_score":2.3978952727983707,"endowment":2.3978952727983707,"self_citation_contribution":0.3596842909197557,"citation_network_contribution":0.0,"self_endowment_contribution":0.3596842909197557,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9159,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":491854,"name":"Sivasubramanium V. Bhavani","orcid":"0000-0002-9640-6720","position":1,"is_corresponding":false},{"id":370997,"name":"Aaloke Mody","orcid":"0000-0003-3787-365X","position":2,"is_corresponding":false},{"id":663298,"name":"Alice F. Bewley","orcid":"0000-0001-5392-4010","position":3,"is_corresponding":false},{"id":954968,"name":"Katherine Dittman","orcid":"0000-0001-8223-4668","position":4,"is_corresponding":false},{"id":955421,"name":"Aisling Doyle","orcid":null,"position":5,"is_corresponding":false},{"id":784809,"name":"Sam Windham","orcid":"0000-0002-3572-8291","position":6,"is_corresponding":false},{"id":955422,"name":"Tej M. Patel","orcid":null,"position":7,"is_corresponding":false},{"id":955423,"name":"Bharat Neelam Raju","orcid":null,"position":8,"is_corresponding":false},{"id":954969,"name":"Matthew Keller","orcid":"0009-0008-0510-6628","position":9,"is_corresponding":false},{"id":252287,"name":"Matthew M. Churpek","orcid":"0000-0002-4030-5250","position":10,"is_corresponding":false},{"id":226852,"name":"Carolyn S. Calfee","orcid":"0000-0001-9208-6865","position":11,"is_corresponding":false},{"id":420203,"name":"Andrew P. Michelson","orcid":"0000-0001-8112-9516","position":12,"is_corresponding":false},{"id":232283,"name":"Thomas Kannampallil","orcid":"0000-0003-4119-4836","position":13,"is_corresponding":false},{"id":371005,"name":"Elvin Geng","orcid":"0000-0002-0825-1424","position":14,"is_corresponding":false},{"id":233689,"name":"Pratik Sinha","orcid":"0000-0003-3751-9079","position":15,"is_corresponding":false},{"id":420205,"name":"Patrick G. Lyons","orcid":"0000-0002-1557-2787","position":0,"is_corresponding":true}],"reference_count":56,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T00:29:03.247347Z","pmid":"36202054","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}