Curating a Knowledge Base for Individuals with Coinfection of HIV and SARS-CoV-2: EHR-based Data Mining

为 HIV 和 SARS-CoV-2 混合感染者打造知识库：基于 EHR 的数据挖掘

基本信息

批准号：
10665078
负责人：
Xiaoming Li
金额：
$ 18.57万
依托单位：
UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-07-13 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10665078
关键词：
2019-nCoV Acquired Immunodeficiency Syndrome Acute Address Adherence CD4 Lymphocyte Count CD4 Positive T Lymphocytes COVID-19 COVID-19 pandemic COVID-19 risk COVID-19 severity COVID-19 vaccination Cardiovascular Diseases Cell Count Cells Characteristics Chronic Kidney Failure Chronic Obstructive Pulmonary Disease Clinic Clinical Clinical Data Clinical Trials Clinical Trials Design Collaborations Consultations Country Data Dependence Development Diagnosis Disparity Electronic Health Record Etiology Event Goals HIV HIV Infections Health Hospitalization Human immunodeficiency virus test Immune Individual Inflammatory Intervention Knowledge Laboratories Malignant Neoplasms Measures Methodology Modeling Natural History Non-Insulin-Dependent Diabetes Mellitus Obesity Ontology Outcome Pathway interactions Patients Pattern Pharmaceutical Preparations Phase Phenotype Population Post-Acute Sequelae of SARS-CoV-2 Infection Procedures Prognosis Provider Public Health Reporting Risk Risk Factors Role SARS-CoV-2 exposure SARS-CoV-2 infection Sampling Series Services Severe Acute Respiratory Syndrome Severities Social Behavior Structure System Therapeutic Time Training Viral Viral Load result Visit Work World Health Organization antiretroviral therapy biomedical ontology clinical decision support clinically actionable co-infection cohort comorbidity coronavirus disease data integration data mining demographics design disease prognosis electronic health record system evidence base high risk knowledge base machine learning model outreach patient screening pilot test pre-exposure prophylaxis prisma prospective prototype screening severe COVID-19 social health determinants substance use therapy adherence trait usability

项目摘要

PROJECT SUMMARY The COVID-19 pandemic has cast a heavy burden on individuals with HIV infection. Based on data of 15,522 hospitalized patients with the coinfection of HIV and SARS-CoV-2 from 24 countries, a recent World Health Organization (WHO) report for the first time confirmed that HIV to be an independent risk factor for severe COVID-19. Despite a generally high risk of severe COVID-19 clinical course in individuals with HIV, the interactions between SARS-CoV-2 and HIV infections remain unclear. For example, the severity of COVID-19 in individuals with HIV is correlated with certain comorbidities in which some of these comorbidities are more prevalent in patients with HIV than other populations. Yet, several contradictory findings suggested the predominant role of comorbidities in the severity of COVID-19 regardless of HIV infection. Individuals with low CD4+ T-cell count (e.g., <200~500 cells/µL) and unsuppressed viral load are associated with severe clinical course, yet the role of antiretroviral therapy (ART) exposure and adherence in the context of COVID-19 exposure needs to be examined. Risk factors for the severe clinical course of the coinfection are undetermined because individuals with the same or similar severity level of COVID-19 show different clinical characteristics. To fill address these knowledge gaps, this study will establish an EHR-based cohort for individuals with HIV/SARS- CoV-2 coinfection and develop large-scale EHR-based data mining to examine the interactions between HIV and SARS-CoV-2 infections and systematically identify and validate factors contributing to the severe clinical course of the coinfection. Ultimately, collected clinical evidence will be implemented and used to pilot test a Clinical Decision Support (CDS) prototype to assist providers in screening and referral of at-risk patients in real-world clinics.

项目概要根据 15,522 名艾滋病毒感染者的数据，COVID-19 大流行给艾滋病毒感染者带来了沉重的负担。世界卫生组织最近发布的一份报告显示，来自 24 个国家/地区的住院患者同时感染 HIV 和 SARS-CoV-2 世界卫生组织（WHO）报告首次证实艾滋病毒是重症患者的独立危险因素尽管 HIV 感染者出现严重 COVID-19 临床病程的风险普遍较高，但 SARS-CoV-2 和 HIV 感染之间的相互作用仍不清楚，例如，COVID-19 的严重程度。 HIV 感染者与某些合并症相关，其中一些合并症更严重。然而，一些相互矛盾的研究结果表明，艾滋病毒感染者中的这种情况比其他人群更为普遍。无论 HIV 感染程度如何，合并症在 COVID-19 严重程度中起主导作用。 CD4+ T 细胞计数（例如，<200~500 个细胞/μL）和未抑制的病毒载量与严重的临床症状相关当然，但抗逆转录病毒治疗 (ART) 暴露和坚持在 COVID-19 暴露背景下的作用需要检查严重合并感染临床病程的危险因素，因为 COVID-19 严重程度相同或相似的个体表现出不同的临床特征。为了解决这些知识差距，本研究将为 HIV/SARS 患者建立一个基于 EHR 的队列 CoV-2 共感染并开发基于 EHR 的大规模数据挖掘，以检查 HIV 和 SARS-CoV-2 感染并系统地识别和验证导致严重临床病程的因素最终，收集的临床证据将被实施并用于临床试验。决策支持 (CDS) 原型可帮助提供者在现实世界中筛查和转诊高危患者诊所。