Pediatric COVID-19 Dashboard and Clinical Phenotypes

项目概要/摘要 儿科 COVID-19 是一个重大的国家和全球公共卫生问题。 SARS-CoV-2 引起两种类型的 严重儿科疾病：急性 COVID-19 和儿童多系统炎症综合征 (MIS-C)。两者都 急性COVID-19和MIS-C可导致器官功能障碍和死亡。孩子们通常经历过 COVID-19 疾病的严重程度比成人轻。然而，在由三角洲和 SARS-CoV-2 的 omicron 变体，儿科卫生系统难以满足其社区的需求 和地区。同时发生的心理健康危机、人员配备也推动了医院需求高峰期 挑战和病毒的非周期传播会导致不成比例的儿科影响（例如呼吸道疾病） 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 通过显示有关儿科 COVID-19 住院率和严重程度轨迹的信息 在公共仪表板上显示分布情况以及病毒合并感染情况，并定期向联邦提交这些数据 决策者。新的变种可能会发展和传播。一种毒性更强、对疫苗具有抗性的变体 可能引发新一轮病例激增。这种激增可能会再次使儿科卫生系统的功能面临风险， 提出了 COVID-19 的新儿科临床表型。本补充文件的总体目标是使 有关儿科 COVID-19 住院率和疾病严重程度轨迹的信息以及 独特的儿科 COVID-19 临床表型可随时用于国家级决策。我们 将进一步开发计算管道来分析儿童 COVID-19 住院轨迹 率和疾病严重程度，并扩展我们的交互式儿科 COVID-19 严重程度仪表板，以实现近实时 跟踪 SARS-CoV-2 大流行的影响。为此，我们将利用国家新冠肺炎队列 Collaborative (N3C)，一种由国家转化推进中心资助开发的资源 科学（NCATS）。 N3C 汇总了来自 70 多个美国中心的电子健康记录 (EHR) 数据。在 我们之前的工作，我们已经证明了我们分析 N3C 中精细的多中心 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 与本提案中的内容类似。我们将利用N3C中这些丰富的EHR数据来完成以下具体工作 目标：1A) 维护、扩展和传播交互式儿科 COVID-19 仪表板和 1B) 监测 并报告儿科新冠肺炎 (COVID-19) 临床表型。我们已经组建了一个调查小组 在该领域拥有成功的记录，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。我们期望本补充文件能够对以下领域产生强大而持续的影响： 通过降低不堪重负的可能性来制定 COVID-19 政策和受影响儿童的结果 美国儿科卫生系统。

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.