Informatics community using EHR data to answer COVID-19 questions

Informatics Community Using EHR Data to Answer COVID-19 Questions: Featuring the Acute Kidney Injury (AKI) & Critical Care/Ventilation/Multi-organ Dysfunction Syndrome (MODS) Domain Teams

The National COVID Cohort Collaborative (N3C) is open for research with over 2 million patients and 2 billion rows of data from more than 35 sites. Nineteen multidisciplinary Domain Teams composed of clinical and subject matter experts, statisticians, informaticists, and machine learning specialists are addressing the most pressing clinical questions. N3C data can be utilized to understand COVID-19's impact on health, facilitate the collection of pilot data for grant submissions, train algorithms on larger datasets, and use tools for large-scale COVID-19 data. In this issue, we feature the Acute Kidney Injury (AKI) and the Critical Care/Ventilation/Multi-organ Dysfunction Syndrome (MODS) Clinical Domain Teams.

The Acute Kidney Injury (AKI) Clinical Domain Team, co-led by Sandeep Mallipattu, MD, FASN, Associate Professor of Nephrology at the Renaissance School of Medicine at Stony Brook University and Richard Moffitt, PhD Assistant Professor of Biomedical Informatics at Stony Brook University, aims to investigate risk factors associated with kidney injury and recovery, as well as use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) in kidney disease. Their research involves the assessment of risk factors, predictors, duration, dialysis need and timing, clinical measures, and interventions for COVID-19-related complications of the kidney. The team also collaborates with other nephrology domain experts.

The AKI Domain team has several active projects in the N3C Data Enclave: Acute Kidney Injury in Pediatric COVID-19 Patients, lead investigator Adam Dziorny, University of Rochester; Continued In-Hospital ACEi and ARB Use in Hypertensive COVID-19 Patients, lead investigator Tim Duong, Albert Einstein College of Medicine; Epidemiology of Acute and Chronic Kidney Injury Associated SARS-CoV-2 Infection, lead investigator Chirag Parikh, Johns Hopkins University; NIRVANA, lead investigator Joel Michalek, The University of Texas Health Science Center at San Antonio.

The Critical Care/Ventilation/Multi-organ Dysfunction Syndrome (MODS) Clinical Domain Team is co-led by Vignesh Subbian, PhD, Assistant Professor of Biomedical Engineering, University of Arizona; Rishi Kamaleswaran, PhD, Director of Translational Clinical Informatics, Emory University; Randeep Jawa, MD, Deputy Chief Medical Information Officer, Stony Brook Medicine; and Greg Martin, MD, MSc, Executive Associate Division Director, Divisions of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University. This team, one of few “joint” N3C Domain Teams, aims to better understand and characterize complex disease trajectories including multiple organ dysfunction, along with determination of treatment efficacies to improve outcomes in critically ill patients with COVID-19. The vision of this Domain Team is to understand the pathophysiology of the SARS-CoV-2 virus on single and multi-organ systems, and what determines optimal treatment strategies affecting short- and longer-term outcomes of critically ill COVID-19 patients. The ventilation subgroup is focused on defining critical care cohorts based on ventilation strategies, as well as studying clinical outcomes on intubated patients versus those not intubated. The MODS subgroup focuses on characterizing multi-organ dysfunction as a temporal trajectory and probabilistic process.

The Critical Care/Ventilation/MODS Domain team has the following active projects in the N3C Data Enclave: Clinical Characterization of Critically-ill COVID-19 Patients based on Ventilation Strategy, lead investigator Vignesh Subbian, University of Arizona; Deep learning of longitudinal chest X-ray and clinical variables to predict needs for invasive mechanical ventilation and mortality in COVID-19 patients, lead investigator Tim Duong, Albert Einstein School of Medicine; Multiorgan Dysfunction Syndrome and Complex Clinical Trajectory, lead investigator Rishikesan Kamaleswaran, Emory University; Predicting organ failure in patients with COVID-19, lead investigator Chengda Zhang, Oregon Health & Science University; Understanding non-invasive ventilation treatment failures in COVID-19, lead investigator Ivy Benjenk, George Washington University.

N3C encourages researchers with various backgrounds, expertise and career level to join a Domain Team that represents their interests or to suggest new areas to explore. A Domain Team can submit one or more research projects; however, collaboration is encouraged for similar concepts.

If you are interested in joining a Domain Team, please visit the N3C Domain Teams web page. You can also learn about N3C projects through the N3C Data Enclave Projects page.