Pediatric COVID-19 Dashboard and Clinical Phenotypes

项目概要/摘要 儿童COVID-19是一个重大的国家和全球公共卫生问题。SARS-CoV-2导致两种类型的 重症儿科疾病：急性COVID-19和儿童多系统炎症综合征（MIS-C）。两 急性COVID-19和MIS-C可导致器官功能障碍和死亡。孩子们通常会经历 COVID-19疾病的严重程度比成人轻。然而，在由三角洲和 由于SARS-CoV-2的omicron变体，儿科卫生系统努力支持其社区的需求， 和地区医院需求高峰期也是由同时发生的心理健康危机、人员配置 挑战，以及造成不成比例的儿科影响的病毒非周期传播（例如，呼吸 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 通过展示儿童COVID-19住院率和严重程度的轨迹信息， 分布以及病毒共感染的公共仪表板上，并定期提交这些数据给联邦 决策者。新的变种可能会发展和传播。一种毒性更强、对疫苗更有抵抗力的变种 可能会引发新一轮的病例激增这种激增可能再次使儿科卫生系统的功能处于危险之中， 呈现新的COVID-19儿科临床表型。本补编的总体目标是使 儿童COVID-19住院率和疾病严重程度的轨迹信息， 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，以分析儿科COVID-19住院的轨迹 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， 追踪SARS-CoV-2大流行的影响。为此，我们将利用国家新冠肺炎队列 协作（N3 C），由国家促进翻译中心资助开发的资源 科学（NCATS）。N3 C汇集了来自70多个美国中心的电子健康记录（EHR）数据。在 我们先前的工作，我们已经证明了我们的能力，分析粒度多中心EHR数据在N3 C， 利用N3 C平台上最先进的计算资源，并实施分析技术 与本提案中的类似。我们将在N3 C中使用这些丰富的EHR数据来完成以下具体工作 目的：1A）维护，扩展和传播交互式儿科COVID-19仪表板和1B）监测 并报告紧急儿科COVID-19临床表型。我们召集了一个调查小组 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。我们希望这一补充将产生强大和持续的影响， COVID-19政策制定和受影响儿童的结果，通过减少不堪重负的可能性 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.