Deep interpretable learning of sample representations for characterizing disease states in single-cell transcriptomics

Single-cell transcriptomics technology offers unprecedented insights into molecular heterogeneity. However, capturing sample-level representations that reflect both systemic and cellular states remains challenging, especially when disease annotations are mostly available as coarse sample-level labels. Here, we introduce Phenoverse, an interpretable deep learning framework that learns sample-level disease state representations through cell type-aware residual encoding, prototype learning, and Perceiver-based aggregation. Applied to independent single-cell transcriptomic cohorts of COVID-19, Alzheimer’s disease, and systemic lupus erythematosus, totaling over 5 million cells, we demonstrate that learned sample representations enable disease state prediction and encode a continuous spectrum of disease severity on unseen data that correlate with multiple clinical and pathological measures, despite being trained solely on binary phenotype labels. Further, we demonstrate that trajectory-derived genes reveal cross-cohort molecular programs and show consistently higher reproducibility than traditional case-control comparisons. Finally, prototype learning provides intrinsic model interpretability and enables the characterization of cell type-specific disease states. Taken together, Phenoverse offers an interpretable disease-phenotyping approach to dissecting sample heterogeneity, and our results highlight its utility in translating complex single-cell transcriptomic data into patient-level biological insights.