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

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

There was greater between-hospital variation for laboratory test performance than between-country variation ( Figure 6 ). At the time of diagnosis, there was significant variation between countries and between the hospitals in a specific country. There was no obvious signature presentation for a country for an individual laboratory value. For example, creatinine was a commonly performed laboratory study within a day of diagnosis. The overall standard deviation (SD) for creatinine values across countries was 1.47 while the SD within sites was 1.39. Standard deviation for countries was 1.64, 1.31, 1.13, and 1.62 within France, Germany, Italy, and the US, respectively. France was a special case as 39 hospitals were reported together by AP-HP and then compared with three hospitals in Bordeaux. This was an important finding that could suggest that laboratory values, as individual results, would not be able to fully explain the mortality differences between countries.