{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:02:57Z","timestamp":1790395377092,"version":"4.1.0"},"reference-count":20,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T00:00:00Z","timestamp":1603929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: Different clinical presentations in COVID-19 are described to date, from mild to severe cases. 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. (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. (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). The main pre-admission comorbidities were arterial hypertension (6030, 50%), hyperlipidemia (4741, 39.4%) and diabetes mellitus (2309, 19.2%). The average number of days from COVID-19 symptom onset to hospital admission was 6.7 (SD 7). The triad of fever, cough, and dyspnea was present almost uniformly in all 4 clinical phenotypes identified by clustering. Cluster C1 (8737 patients, 72.4%) was the largest, and comprised patients with the triad alone. 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. Compared to each other, cluster C1 presented the highest in-hospital mortality (24.1% vs. 4.3% vs. 14.7% vs. 18.6%; p &lt; 0.001). The multivariate study identified age, gender (male), body mass index (BMI), arterial hypertension, chronic obstructive pulmonary disease (COPD), ischemic cardiopathy, chronic heart failure, chronic hepatopathy, Charlson\u2019s index, heart rate and respiratory rate upon admission &gt;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. (4) Conclusions: The present study identified 4 phenotypic clusters in patients with COVID-19 pneumonia, which predicted the in-hospital prognosis of clinical outcomes.<\/jats:p>","DOI":"10.3390\/jcm9113488","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T23:06:12Z","timestamp":1604012772000},"page":"3488","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Predicting Clinical Outcome with Phenotypic Clusters in COVID-19 Pneumonia: An Analysis of 12,066 Hospitalized Patients from the Spanish Registry SEMI-COVID-19"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9548-1374","authenticated-orcid":false,"given":"Manuel","family":"Rubio-Rivas","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9889-0272","authenticated-orcid":false,"given":"Xavier","family":"Corbella","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, 08907 Barcelona, Spain"},{"name":"Hestia Chair in Integrated Health and Social Care, School of Medicine, Universitat Internacional de Catalunya, 08017 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Mora-Luj\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6451-8971","authenticated-orcid":false,"given":"Jose","family":"Loureiro-Amigo","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Mois\u00e8s Broggi Hospital, Sant Joan Desp\u00ed, 08970 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almudena","family":"L\u00f3pez Sampalo","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Regional University Hospital of M\u00e1laga, 29010 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Yera Bergua","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Virgen de la Salud Hospital, 45071 Toledo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Jes\u00fas","family":"Esteve Ati\u00e9nzar","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, San Juan de Alicante University Hospital, San Juan de Alicante, 03550 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Felipe","family":"D\u00edez Garc\u00eda","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Torrec\u00e1rdenas Hospital, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Gonzalez Ferrer","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Tajo Hospital, Aranjuez, 28300 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Plaza Canteli","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Severo Ochoa University Hospital, Legan\u00e9s, 28914 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ant\u00eda","family":"P\u00e9rez Pi\u00f1eiro","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Valle del Nal\u00f3n Hospital, Ria\u00f1o, Langreo, 33920 Asturias, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bego\u00f1a","family":"Cort\u00e9s Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Alto Guadalquivir Hospital, And\u00fajar, 23740 Ja\u00e9n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leyre","family":"Jorquer Vidal","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Francesc de Borja Hospital, Gandia, 46702 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2146-378X","authenticated-orcid":false,"given":"Ignacio","family":"P\u00e9rez Catal\u00e1n","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Castell\u00f3n General University Hospital, 12004 Castell\u00f3n de la Plana, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Le\u00f3n T\u00e9llez","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Santa B\u00e1rbara Hospital, 42005 Soria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5598-5180","authenticated-orcid":false,"given":"Jos\u00e9 \u00c1ngel","family":"Mart\u00edn Oterino","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Salamanca University Hospital Complex, 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Candelaria","family":"Mart\u00edn Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Canarias University Hospital, 38320 Santa Cruz de Tenerife, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Serrano Carrillo de Albornoz","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Poniente Hospital, 04700 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Garc\u00eda Sardon","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, San Pedro de Alc\u00e1ntara Hospital, 10003 C\u00e1ceres, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Nicol\u00e1s","family":"Alcal\u00e1 Pedrajas","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Pozoblanco Hospital, Pozoblanco, 14400 C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anabel","family":"Martin-Urda Diez-Canseco","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Palam\u00f3s Hospital, Palam\u00f3s, 17230 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Esteban Giner","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Virgen de los Lirios Hospital, Alcoy, 03804 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Teller\u00eda G\u00f3mez","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Valladolid Clinical University Hospital, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6501-9867","authenticated-orcid":false,"given":"Jos\u00e9 Manuel","family":"Ramos-Rinc\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Miguel Hernandez University of Elche, 03203 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9909-3555","authenticated-orcid":false,"given":"Ricardo","family":"G\u00f3mez-Huelgas","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Regional University Hospital of M\u00e1laga, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA), 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study","volume":"395","author":"Zhou","year":"2020","journal-title":"Lancet"},{"key":"ref_2","unstructured":"Novel Coronavirus Pneumonia Emergency Response Epidemiology Team (2020, March 12). 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