Pediatric COVID-19 Severity Dashboard During Delta Variant Circulation

PROJECT SUMMARY/ABSTRACT Pediatric COVID-19 is a major national and global public health problem. Pediatric COVID-19 cases have been increasing since mid-July 2021, coincident with the predominance of the Delta variant. During most of the pandemic, children have typically experienced milder COVID-19 illness severity than adults. However, 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. Recently, individual pediatric health systems have reported increasing numbers of hospitalized patients who are positive for SARS-CoV-2 (July-August 2021). Because children under 12 are not yet eligible for SARS-CoV-2 vaccines and most are returning to in-person school this fall, they will be potentially more vulnerable to SARS-CoV-2 infection than in the past. However, it is not known if the Delta variant causes higher severity disease in children, as it does in adults. If it does, then increased transmission as children return to in-person school could cause demand for inpatient and intensive care unit (ICU) services at pediatric health systems to outstrip supply. Second, granular national data are not readily available. The overall objective of this Supplement is to make information about the trajectories of pediatric COVID-19 hospitalization rates and disease severity readily available for national-level decision-making. We will implement pipelines to analyze the trajectories of pediatric COVID-19 hospitalization rates and build an interactive pediatric COVID-19 severity dashboard for near-real-time tracking of the pediatric 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 60 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) visualize and test the trends of pediatric COVID-19 hospitalization rates and disease severity over time and 1B) design and build an interactive pediatric COVID-19 severity dashboard. We have assembled an investigative team with a successful track record in the field and will work in partnership with NIH and N3C leadership to address this national and global health priority. We expect the results of this Supplement proposal to have a powerful and immediate impact on the outcomes of children with COVID-19 and pediatric COVID-19 policy-making by decreasing the likelihood of overwhelmed U.S. pediatric health systems.