International Electronic Health Record-Derived COVID-19 Clinical Course Profiles: The 4CE Consortium

Brat, Gabriel A; Weber, Griffin M; Gehlenborg, Nils; Avillach, Paul; Palmer, Nathan P; Chiovato, Luca; Cimino, James; Waitman, Lemuel R; Omenn, Gilbert S; Malovini, Alberto; Moore, Jason H; Beaulieu-Jones, Brett K; Tibollo, Valentina; Murphy, Shawn N; L'Yi, Sehi; Keller, Mark S; Bellazzi, Riccardo; Hanauer, David A; Serret-Larmande, Arnaud; Gutierrez-Sacristan, Alba; Holmes, John J; Bell, Douglas S; Mandl, Kenneth D; Follett, Robert W; Klann, Jeffrey G; Murad, Douglas A; Scudeller, Luigia; Bucalo, Mauro; Kirchoff, Katie; Craig, Jean; Obeid, Jihad; Jouhet, Vianney; Griffier, Romain; Cossin, Sebastien; Moal, Bertrand; Patel, Lav P; Bellasi, Antonio; Prokosch, Hans U; Kraska, Detlef; Sliz, Piotr; Tan, Amelia LM; Ngiam, Kee Yuan; Zambelli, Alberto; Mowery, Danielle L; Schiver, Emily; Devkota, Batsal; Bradford, Robert L; Daniar, Mohamad; Daniel, Christel; Benoit, Vincent; Bey, Romain; Paris, Nicolas; Serre, Patricia; Orlova, Nina; Dubiel, Julien; Hilka, Martin; Jannot, Anne Sophie; Breant, Stephane; Leblanc, Judith; Griffon, Nicolas; Burgun, Anita; Bernaux, Melodie; Sandrin, Arnaud; Salamanca, Elisa; Ganslandt, Thomas; Gradinger, Tobias; Champ, Julien; Boeker, Martin; Martel, Patricia; Gramfort, Alexandre; Grisel, Olivier; Leprovost, Damien; Moreau, Thomas; Varoquaux, Gael; Vie, Jill Jen; Wassermann, Demian; Mensch, Arthur; Caucheteux, Charlotte; Haverkamp, Christian; Lemaitre, Guillaume; Cai, Tianxi; Kohane, Isaac S

We leveraged the largely untapped resource of electronic health record data to address critical clinical and epidemiological questions about Coronavirus Disease 2019 (COVID-19). To do this, we formed an international consortium (4CE) of 96 hospitals across 5 countries (www.covidclinical.net). Contributors utilized the Informatics for Integrating Biology and the Bedside (i2b2) or Observational Medical Outcomes Partnership (OMOP) platforms to map to a common data model. The group focused on comorbidities and temporal changes in key laboratory test values. Harmonized data were analyzed locally and converted to a shared aggregate form for rapid analysis and visualization of regional differences and global commonalities. Data covered 27,584 COVID-19 cases with 187,802 laboratory tests. Case counts and laboratory trajectories were concordant with existing literature. Laboratory tests at the time of diagnosis showed hospital-level differences equivalent to country-level variation across the consortium partners. Despite the limitations of decentralized data generation, we established a framework to capture the trajectory of COVID-19 disease in patients and their response to interventions.