Evidence map›Paper›PMID 40247607›Full record

ArticleAmerican journal of hypertension2025

A Transformer-Based Framework for Counterfactual Estimation of Antihypertensive Treatment Effect on COVID-19 Infection Risk - A Proof-of-Concept Study.

Tran Q B Tran, Stefanie Lip, Honghan Wu, Shyam Visweswaran, Jill P Pell, Sandosh Padmanabhan

Abstract read
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Article in American journal of hypertension, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Tran Q B TranSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.ORCID 0000-0001-6829-6432
Stefanie LipSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
Honghan WuSchool of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Shyam VisweswaranUniversity of Pittsburgh School of Medicine, Pittsburgh, PA, USA.ORCID 0000-0002-2079-8684
Jill P PellSchool of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Sandosh PadmanabhanSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.ORCID 0000-0003-3869-5808

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransformer-based neural networks excel in modelling high-dimensional, time-series data with complex dependencies. This proof-of-concept study applies a transformer-X-learner framework to estimate treatment effects using real-world data, using antihypertensive drug exposure and COVID-19 risk as an exemplar.

methodsWe conducted a case-control study of 303,220 NHS Greater Glasgow and Clyde patients aged ≥ 40 years during the first two COVID-19 pandemic waves. Using a transformer-X-learner framework that incorporated temporal patterns in medication usage and comorbidities, we controlled for confounding effects and estimated individual and average treatment effects ACEIs, beta-blockers (BBs), calcium channel blockers (CCBs), thiazides (THZs), and statins on 180-day SARS-CoV-2 infection risk.

resultsThe transformer-X-learner framework outperformed traditional approaches, achieving an F1 score of 0.82 and area under the precision-recall curve (AUPRC) of 0.78. ACEIs showed a negligible overall impact on COVID-19 risk (ATE: 0.97%±5.5), while BBs (-8.3%±7.3%) and CCBs (-9.7%±8.1%) were protective. Statins (3.5%±6.1%) and THZs (4.3%±10.8%) showed slight increases in risk. Treatment effects were consistent across age, gender, and socioeconomic categories.

conclusionsACEIs do not substantially increase the risk of COVID-19 infection while the protective effects of BBs and CCBs warrant further investigation. This study highlights the potential of transformer-based causal inference models as a powerful tool for evaluating treatment safety and efficacy in complex healthcare scenarios.

Indexed as

Antihypertensive AgentsCOVID-19HypertensionNeural Networks, ComputerAdultAgedCalcium Channel BlockersCase-Control StudiesFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedProof of Concept StudyRisk AssessmentRisk FactorsAntihypertensive AgentsCalcium Channel BlockersHydroxymethylglutaryl-CoA Reductase Inhibitorsangiotensin-converting enzyme inhibitorsantihypertensive agentsbeta blockerscalcium channel blockerscounterfactual inferenceCOVID-19deep learningneural networkthiazides

Identifiers

PMID40247607
PMCPMC12260164

What Socratic holds

Texttitle and abstract
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.