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Luo Y, Mao C, Sanchez‐Pinto LN, Ahmad FS, Naidech A, Rasmussen L, Pacheco JA, Schneider D, Mithal LB, Dresden S, Holmes K, Carson M, Shah SJ, Khan S, Clare S, Wunderink RG, Liu H, Walunas T, Cooper L, Yue F, Wehbe F, Fang D, Liebovitz DM, Markl M, Michelson KN, McColley SA, Green M, Starren J, Ackermann RT, D'Aquila RT, Adams J, Lloyd‐Jones D, Chisholm RL, Kho A. Northwestern University resource and education development initiatives to advance collaborative artificial intelligence across the learning health system. Learn Health Syst 2024; 8:e10417. [PMID: 39036530 PMCID: PMC11257059 DOI: 10.1002/lrh2.10417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction The rapid development of artificial intelligence (AI) in healthcare has exposed the unmet need for growing a multidisciplinary workforce that can collaborate effectively in the learning health systems. Maximizing the synergy among multiple teams is critical for Collaborative AI in Healthcare. Methods We have developed a series of data, tools, and educational resources for cultivating the next generation of multidisciplinary workforce for Collaborative AI in Healthcare. We built bulk-natural language processing pipelines to extract structured information from clinical notes and stored them in common data models. We developed multimodal AI/machine learning (ML) tools and tutorials to enrich the toolbox of the multidisciplinary workforce to analyze multimodal healthcare data. We have created a fertile ground to cross-pollinate clinicians and AI scientists and train the next generation of AI health workforce to collaborate effectively. Results Our work has democratized access to unstructured health information, AI/ML tools and resources for healthcare, and collaborative education resources. From 2017 to 2022, this has enabled studies in multiple clinical specialties resulting in 68 peer-reviewed publications. In 2022, our cross-discipline efforts converged and institutionalized into the Center for Collaborative AI in Healthcare. Conclusions Our Collaborative AI in Healthcare initiatives has created valuable educational and practical resources. They have enabled more clinicians, scientists, and hospital administrators to successfully apply AI methods in their daily research and practice, develop closer collaborations, and advanced the institution-level learning health system.
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Affiliation(s)
- Yuan Luo
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Division of Health and Biomedical Informatics, Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Chengsheng Mao
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Division of Health and Biomedical Informatics, Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Lazaro N. Sanchez‐Pinto
- Division of Health and Biomedical Informatics, Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Division of Critical Care, Department of PediatricsNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Stanley Manne Children's Research InstituteAnn & Robert H. Lurie Children's Hospital of ChicagoChicagoIllinoisUSA
| | - Faraz S. Ahmad
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Division of Cardiology, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Andrew Naidech
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Division of Neurocritical Care, Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Luke Rasmussen
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Division of Health and Biomedical Informatics, Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Jennifer A. Pacheco
- Center for Genetic MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Daniel Schneider
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
| | - Leena B. Mithal
- Stanley Manne Children's Research InstituteAnn & Robert H. Lurie Children's Hospital of ChicagoChicagoIllinoisUSA
- Division of Infectious Diseases, Department of PediatricsNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Scott Dresden
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Department of Emergency MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Kristi Holmes
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Division of Health and Biomedical Informatics, Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Galter Health Sciences LibraryNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Matthew Carson
- Galter Health Sciences LibraryNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Sanjiv J. Shah
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Division of Cardiology, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Seema Khan
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Department of SurgeryNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Susan Clare
- Department of SurgeryNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Richard G. Wunderink
- Division of Critical Care, Department of PediatricsNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Pulmonary and Critical Care Division, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Huiping Liu
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Department of PharmacologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Division of Hematology and Oncology, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Theresa Walunas
- Division of Health and Biomedical Informatics, Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Division of General Internal Medicine, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Center for Health Information PartnershipsInstitute for Public Health and Medicine, Northwestern UniversityChicagoIllinoisUSA
- Department of Microbiology‐ImmunologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Lee Cooper
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Division of Health and Biomedical Informatics, Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Department of PathologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Feng Yue
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Department of PathologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Department of Biochemistry and Molecular GeneticsNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Firas Wehbe
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Department of SurgeryNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Deyu Fang
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Department of PathologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - David M. Liebovitz
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Division of Health and Biomedical Informatics, Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Division of General Internal Medicine, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Center for Health Information PartnershipsInstitute for Public Health and Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - Michael Markl
- Department of RadiologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Kelly N. Michelson
- Division of Critical Care, Department of PediatricsNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Stanley Manne Children's Research InstituteAnn & Robert H. Lurie Children's Hospital of ChicagoChicagoIllinoisUSA
- Center for Bioethics and Medical Humanities, Institute for Public Health and MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Susanna A. McColley
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Stanley Manne Children's Research InstituteAnn & Robert H. Lurie Children's Hospital of ChicagoChicagoIllinoisUSA
- Division of Pulmonary and Sleep Medicine, Department of PediatricsNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Marianne Green
- Division of General Internal Medicine, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Justin Starren
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Division of Health and Biomedical Informatics, Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Ronald T. Ackermann
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Division of General Internal Medicine, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Institute for Public Health and MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Richard T. D'Aquila
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Division of Infectious Diseases, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - James Adams
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Department of Emergency MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Donald Lloyd‐Jones
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Division of Epidemiology, Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Rex L. Chisholm
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Department of SurgeryNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Center for Health Information PartnershipsInstitute for Public Health and Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - Abel Kho
- Northwestern University Clinical and Translational Sciences InstituteChicagoIllinoisUSA
- Institute for Augmented Intelligence in MedicineNorthwestern UniversityChicagoIllinoisUSA
- Division of Health and Biomedical Informatics, Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Division of General Internal Medicine, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Center for Health Information PartnershipsInstitute for Public Health and Medicine, Northwestern UniversityChicagoIllinoisUSA
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Hutch MR, Son J, Le TT, Hong C, Wang X, Shakeri Hossein Abad Z, Morris M, Gutiérrez-Sacristán A, Klann JG, Spiridou A, Batugo A, Bellazzi R, Benoit V, Bonzel CL, Bryant WA, Chiudinelli L, Cho K, Das P, González González T, Hanauer DA, Henderson DW, Ho YL, Loh NHW, Makoudjou A, Makwana S, Malovini A, Moal B, Mowery DL, Neuraz A, Samayamuthu MJ, Sanz Vidorreta FJ, Schriver ER, Schubert P, Talbert J, Tan ALM, Tan BWL, Tan BWQ, Tibollo V, Tippman P, Verdy G, Yuan W, Avillach P, Gehlenborg N, Omenn GS, Visweswaran S, Cai T, Luo Y, Xia Z. Neurological diagnoses in hospitalized COVID-19 patients associated with adverse outcomes: A multinational cohort study. PLOS DIGITAL HEALTH 2024; 3:e0000484. [PMID: 38620037 PMCID: PMC11018281 DOI: 10.1371/journal.pdig.0000484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/06/2024] [Indexed: 04/17/2024]
Abstract
Few studies examining the patient outcomes of concurrent neurological manifestations during acute COVID-19 leveraged multinational cohorts of adults and children or distinguished between central and peripheral nervous system (CNS vs. PNS) involvement. Using a federated multinational network in which local clinicians and informatics experts curated the electronic health records data, we evaluated the risk of prolonged hospitalization and mortality in hospitalized COVID-19 patients from 21 healthcare systems across 7 countries. For adults, we used a federated learning approach whereby we ran Cox proportional hazard models locally at each healthcare system and performed a meta-analysis on the aggregated results to estimate the overall risk of adverse outcomes across our geographically diverse populations. For children, we reported descriptive statistics separately due to their low frequency of neurological involvement and poor outcomes. Among the 106,229 hospitalized COVID-19 patients (104,031 patients ≥18 years; 2,198 patients <18 years, January 2020-October 2021), 15,101 (14%) had at least one CNS diagnosis, while 2,788 (3%) had at least one PNS diagnosis. After controlling for demographics and pre-existing conditions, adults with CNS involvement had longer hospital stay (11 versus 6 days) and greater risk of (Hazard Ratio = 1.78) and faster time to death (12 versus 24 days) than patients with no neurological condition (NNC) during acute COVID-19 hospitalization. Adults with PNS involvement also had longer hospital stay but lower risk of mortality than the NNC group. Although children had a low frequency of neurological involvement during COVID-19 hospitalization, a substantially higher proportion of children with CNS involvement died compared to those with NNC (6% vs 1%). Overall, patients with concurrent CNS manifestation during acute COVID-19 hospitalization faced greater risks for adverse clinical outcomes than patients without any neurological diagnosis. Our global informatics framework using a federated approach (versus a centralized data collection approach) has utility for clinical discovery beyond COVID-19.
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Affiliation(s)
- Meghan R. Hutch
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Jiyeon Son
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Trang T. Le
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Chuan Hong
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, United States of America
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, United States of America
| | - Xuan Wang
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, United States of America
| | - Zahra Shakeri Hossein Abad
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Michele Morris
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Alba Gutiérrez-Sacristán
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jeffrey G. Klann
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Anastasia Spiridou
- Digital Research, Informatics and Virtual Environments (DRIVE), Great Ormond Street Hospital for Children, London, United Kingdom
| | - Ashley Batugo
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Riccardo Bellazzi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Vincent Benoit
- IT Department, Innovation & Data, APHP Greater Paris University Hospital, Paris, France
| | - Clara-Lea Bonzel
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - William A. Bryant
- Digital Research, Informatics and Virtual Environments (DRIVE), Great Ormond Street Hospital for Children, London, United Kingdom
| | - Lorenzo Chiudinelli
- UOC Ricerca, Innovazione e Brand reputation, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Kelly Cho
- Population Health and Data Science, VA Boston Healthcare System, Boston Massachusetts, United States of America
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston Massachusetts, United States of America
| | - Priyam Das
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | | | - David A. Hanauer
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Darren W. Henderson
- Center for Clinical and Translational Science, University of Kentucky, Lexington, Kentucky, United States of America
| | - Yuk-Lam Ho
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston Massachusetts, United States of America
| | - Ne Hooi Will Loh
- Department of Anaesthesia, National University Health System, Kent Ridge, Singapore
| | - Adeline Makoudjou
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Simran Makwana
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Alberto Malovini
- Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Italy
| | - Bertrand Moal
- IAM Unit, Bordeaux University Hospital, Bordeaux, France
| | - Danielle L. Mowery
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Antoine Neuraz
- Department of biomedical informatics, Hôpital Necker-Enfants Malade, Assistance Publique Hôpitaux de Paris (APHP), University of Paris, Paris, France
| | | | - Fernando J. Sanz Vidorreta
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
| | - Emily R. Schriver
- Data Analytics Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania, United States of America
| | - Petra Schubert
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston Massachusetts, United States of America
| | - Jeffery Talbert
- Division of Biomedical Informatics, University of Kentucky, Lexington, Kentucky, United States of America
| | - Amelia L. M. Tan
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Byorn W. L. Tan
- Department of Medicine, National University Hospital, Singapore, Kent Ridge, Singapore
| | - Bryce W. Q. Tan
- Department of Medicine, National University Hospital, Singapore, Kent Ridge, Singapore
| | - Valentina Tibollo
- Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Italy
| | - Patric Tippman
- Institute of Medical Biometry and University of Freiburg, Medical Center, Freiburg, Germany
| | | | - William Yuan
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Paul Avillach
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Nils Gehlenborg
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Gilbert S. Omenn
- Departments of Computational Medicine & Bioinformatics, Internal Medicine, Human Genetics, Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | | | - Shyam Visweswaran
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Tianxi Cai
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Yuan Luo
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Zongqi Xia
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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Moal B, Orieux A, Ferté T, Neuraz A, Brat GA, Avillach P, Bonzel CL, Cai T, Cho K, Cossin S, Griffier R, Hanauer DA, Haverkamp C, Ho YL, Hong C, Hutch MR, Klann JG, Le TT, Loh NHW, Luo Y, Makoudjou A, Morris M, Mowery DL, Olson KL, Patel LP, Samayamuthu MJ, Sanz Vidorreta FJ, Schriver ER, Schubert P, Verdy G, Visweswaran S, Wang X, Weber GM, Xia Z, Yuan W, Zhang HG, Zöller D, Kohane IS, Boyer A, Jouhet V. Acute respiratory distress syndrome after SARS-CoV-2 infection on young adult population: International observational federated study based on electronic health records through the 4CE consortium. PLoS One 2023; 18:e0266985. [PMID: 36598895 DOI: 10.1371/journal.pone.0266985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 11/09/2022] [Indexed: 01/05/2023] Open
Abstract
PURPOSE In young adults (18 to 49 years old), investigation of the acute respiratory distress syndrome (ARDS) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been limited. We evaluated the risk factors and outcomes of ARDS following infection with SARS-CoV-2 in a young adult population. METHODS A retrospective cohort study was conducted between January 1st, 2020 and February 28th, 2021 using patient-level electronic health records (EHR), across 241 United States hospitals and 43 European hospitals participating in the Consortium for Clinical Characterization of COVID-19 by EHR (4CE). To identify the risk factors associated with ARDS, we compared young patients with and without ARDS through a federated analysis. We further compared the outcomes between young and old patients with ARDS. RESULTS Among the 75,377 hospitalized patients with positive SARS-CoV-2 PCR, 1001 young adults presented with ARDS (7.8% of young hospitalized adults). Their mortality rate at 90 days was 16.2% and they presented with a similar complication rate for infection than older adults with ARDS. Peptic ulcer disease, paralysis, obesity, congestive heart failure, valvular disease, diabetes, chronic pulmonary disease and liver disease were associated with a higher risk of ARDS. We described a high prevalence of obesity (53%), hypertension (38%- although not significantly associated with ARDS), and diabetes (32%). CONCLUSION Trough an innovative method, a large international cohort study of young adults developing ARDS after SARS-CoV-2 infection has been gather. It demonstrated the poor outcomes of this population and associated risk factor.
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Affiliation(s)
- Bertrand Moal
- IAM Unit, Bordeaux University Hospital, Bordeaux, France
| | - Arthur Orieux
- Medical Intensive Care Unit, Bordeaux University Hospital, Bordeaux, France
| | - Thomas Ferté
- Inserm Bordeaux Population Health Research Center UMR 1219, Inria BSO, Team SISTM, University of Bordeaux, Bordeaux, France
| | - Antoine Neuraz
- Department of Biomedical Informatics, Hôpital Necker-Enfants Malade, Assistance Publique Hôpitaux de Paris (APHP), University of Paris, Paris, France
| | - Gabriel A Brat
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Paul Avillach
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Clara-Lea Bonzel
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Tianxi Cai
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Kelly Cho
- Population Health and Data Science, MAVERIC, VA Boston Healthcare System, Boston, Massachusetts, United States of America
| | - Sébastien Cossin
- INSERM Bordeaux Population Health ERIAS TEAM, Bordeaux University Hospital / ERIAS - Inserm U1219 BPH, Bordeaux, France
| | - Romain Griffier
- Institute of Digitalization in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - David A Hanauer
- IAM Unit, INSERM Bordeaux Population Health ERIAS TEAM, Bordeaux University Hospital / ERIAS - Inserm U1219 BPH, Bordeaux, France
| | - Christian Haverkamp
- Department of Learning Health Sciences, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Yuk-Lam Ho
- Institute of Digitalization in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Chuan Hong
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Meghan R Hutch
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America
| | - Jeffrey G Klann
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Trang T Le
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Ne Hooi Will Loh
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Yuan Luo
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Adeline Makoudjou
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Michele Morris
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Danielle L Mowery
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Karen L Olson
- Department of Anaesthesia, National University Health System, Singapore, Singapore
| | - Lav P Patel
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Malarkodi J Samayamuthu
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Fernando J Sanz Vidorreta
- Computational Health Informatics Program, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Emily R Schriver
- Department of Internal Medicine, Division of Medical Informatics, University of Kansas Medical Center, Kansas City, Kansas, United States of America
| | - Petra Schubert
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
| | | | - Shyam Visweswaran
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Xuan Wang
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Griffin M Weber
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Zongqi Xia
- Data Analytics Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania, United States of America
| | - William Yuan
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Harrison G Zhang
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Daniela Zöller
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Isaac S Kohane
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Alexandre Boyer
- Medical Intensive Care Unit, Bordeaux University Hospital, Bordeaux, France
| | - Vianney Jouhet
- Institute of Digitalization in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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4
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Stafstrom CE. Neurological effects of COVID-19 in infants and children. Dev Med Child Neurol 2022; 64:818-829. [PMID: 35243616 PMCID: PMC9111795 DOI: 10.1111/dmcn.15185] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 12/13/2022]
Abstract
Neurological manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children are becoming increasingly apparent as the coronavirus disease (COVID-19) pandemic continues. While children manifest relatively milder features of the disease, accumulating evidence warrants concern that COVID-19 exacts both acute- and long-term effects on the developing central and peripheral nervous systems. This review focuses on the relatively underinvestigated topic of the effects of SARS-CoV-2 on the brain in infancy and childhood, concluding that clinicians should be attentive to both the acute effects and long-term consequences of COVID-19 from a neurological perspective.
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Affiliation(s)
- Carl E. Stafstrom
- Division of Pediatric NeurologyDepartments of Neurology and PediatricsThe Johns Hopkins University School of MedicineBaltimoreMDUSA
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