Pediatric COVID-19 Dashboard and Clinical Phenotypes

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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.