Pediatric COVID-19 Dashboard and Clinical Phenotypes

项目摘要/摘要 儿科新冠肺炎是一个全国性和全球性的重大公共卫生问题。SARS-CoV-2导致两种类型的 严重儿科疾病：急性新冠肺炎和儿童多系统炎症综合征(MISC)。两者都有 急性新冠肺炎和心肌梗死可导致器官功能障碍和死亡。孩子们通常会经历 新冠肺炎的病情严重程度比成年人轻。然而，在三角洲和三角洲引起的大流行激增期间 SARS-CoV-2的欧米克龙变种，儿科卫生系统努力支持他们社区的需求 和地区。医院需求的高峰期也受到同时发生的精神健康危机、人员配备等因素的推动 挑战，以及造成不成比例的儿科影响的病毒的非周期传播(例如，呼吸道 合胞病毒，RSV)。在我们之前的工作中，我们展示了这些激增对儿童和卫生系统的影响 通过公布儿科新冠肺炎住院率和严重程度的轨迹信息 并定期将这些数据提交给联邦政府 决策者。新的变种可能会被开发和传播。一种毒力更强、对疫苗有抵抗力的变种 可能会引发新一轮案件激增。这种激增可能会再次危及儿科卫生系统的功能， 呈现儿科新的新冠肺炎临床表型。本副刊的总体目标是使 关于儿科新冠肺炎住院率和疾病严重程度的轨迹信息 儿科独特的新冠肺炎临床表型，随时可供国家级决策使用。我们 将进一步开发计算管道来分析儿科新冠肺炎住院的轨迹 比率和疾病严重程度，并扩展我们的交互式儿科新冠肺炎严重程度仪表板，以接近实时 追踪SARS-CoV-2大流行的影响。为了做到这一点，我们将利用国家COVID队列 协作性(N3C)，由国家翻译促进中心资助开发的资源 理科(NCATS)。N3C汇总了70多个美国中心的电子健康记录(EHR)数据。在……里面 我们之前的工作，我们已经展示了我们分析N3C多中心细粒度EHR数据的能力， 利用N3C平台上最先进的计算资源，并实施分析技术 类似于本提案中的内容。我们将使用N3C的这些丰富的EHR数据来完成以下具体工作 目标：1)维护、扩展和传播交互式儿科新冠肺炎仪表盘和1)监护仪，用于 并报道了儿科急诊新冠肺炎的临床表型。我们已经组建了一支调查小组 在该领域有着成功的记录，并将与NIH领导层合作解决这一问题 国家和全球卫生优先事项。我们期待这份补编对以下方面产生强大和持续的影响 新冠肺炎政策制定和受影响儿童通过降低不堪重负的可能性而产生的结果 美国的儿科医疗系统。

PROJECT SUMMARY/ABSTRACT Pediatric COVID-19 is a major national and global public health problem. SARS-CoV-2 causes two types of severe pediatric disease: acute COVID-19 and multisystem inflammatory syndrome in children (MIS-C). Both acute COVID-19 and MIS-C can cause organ dysfunction and death. Children have typically experienced milder COVID-19 illness severity than adults. However, during pandemic surges caused by the delta and omicron variants of SARS-CoV-2, pediatric health systems struggled to support the needs of their communities and regions. Periods of peak hospital demand were also driven by simultaneous mental health crises, staffing challenges, and off-cycle transmission of viruses that cause disproportionate pediatric impact (e.g., respiratory syncytial virus, RSV). In our prior work, we showed the impact of these surges on children and health systems by surfacing information about the trajectories of pediatric COVID-19 hospitalization rates and severity distributions as well as viral co-infection on a public dashboard and regularly presented these data to federal decision-makers. Novel variants are likely to develop and spread. A more virulent and vaccine-resistant variant could trigger a new surge in cases. Such a surge could again put pediatric health system function at risk and present new pediatric clinical phenotypes of COVID-19. The overall objective of this Supplement is to make information about the trajectories of pediatric COVID-19 hospitalization rates and disease severity and unique pediatric COVID-19 clinical phenotypes readily available for national-level decision-making. We will further develop computational pipelines to analyze the trajectories of pediatric COVID-19 hospitalization rates and disease severity and extend our interactive pediatric COVID-19 severity dashboard for near-real-time tracking of the impact of the SARS-CoV-2 pandemic. To do this, we will leverage the National COVID Cohort Collaborative (N3C), a resource developed with funding from the National Center for Advancing Translational Sciences (NCATS). N3C aggregates electronic health record (EHR) data from more than 70 U.S. centers. In our prior work, we have demonstrated our ability to analyze the granular multicenter EHR data in N3C, leverage state-of-the-art computational resources on the N3C platform, and implement analytic techniques similar to those in this proposal. We will use these rich EHR data in N3C to accomplish the following specific aim: 1A) maintain, extend, and disseminate an interactive pediatric COVID-19 dashboard and 1B) monitor for and report on emergent pediatric COVID-19 clinical phenotypes. We have assembled an investigative team with a successful track record in the field and will work in partnership with NIH leadership to address this national and global health priority. We expect this Supplement to have a powerful and sustained impact on COVID-19 policymaking and the outcomes of affected children by decreasing the likelihood of overwhelmed U.S. pediatric health systems.