International electronic health record-derived COVID-19 clinical course profiles: the 4CE consortium

Gabriel A. Brat, Griffin M. Weber, Nils Gehlenborg, Paul Avillach, Nathan P. Palmer, Luca Chiovato, James Cimino, Lemuel R. Waitman, Gilbert S. Omenn, Alberto Malovini, Jason H. Moore, Brett K. Beaulieu-Jones, Valentina Tibollo, Shawn N. Murphy, Sehi L’ Yi, Mark S. Keller, Riccardo Bellazzi, David A. Hanauer, Arnaud Serret-Larmande, Alba Gutierrez-SacristanJohn J. Holmes, Douglas S. Bell, Kenneth D. Mandl, Robert W. Follett, Jeffrey G. Klann, Douglas A. Murad, Luigia Scudeller, Mauro Bucalo, Katie Kirchoff, Jean Craig, Jihad Obeid, Vianney Jouhet, Romain Griffier, Sebastien Cossin, Bertrand Moal, Lav P. Patel, Antonio Bellasi, Hans U. Prokosch, Detlef Kraska, Piotr Sliz, Amelia L.M. Tan, Kee Yuan Ngiam, Alberto Zambelli, Danielle L. Mowery, Emily Schiver, Batsal Devkota, Robert L. Bradford, Mohamad Daniar, Christel Daniel, Silvano Bosari

Research output: Contribution to journalArticlepeer-review


We leveraged the largely untapped resource of electronic health record data to address critical clinical and epidemiological questions about Coronavirus Disease 2019 (COVID-19). To do this, we formed an international consortium (4CE) of 96 hospitals across five countries ( Contributors utilized the Informatics for Integrating Biology and the Bedside (i2b2) or Observational Medical Outcomes Partnership (OMOP) platforms to map to a common data model. The group focused on temporal changes in key laboratory test values. Harmonized data were analyzed locally and converted to a shared aggregate form for rapid analysis and visualization of regional differences and global commonalities. Data covered 27,584 COVID-19 cases with 187,802 laboratory tests. Case counts and laboratory trajectories were concordant with existing literature. Laboratory tests at the time of diagnosis showed hospital-level differences equivalent to country-level variation across the consortium partners. Despite the limitations of decentralized data generation, we established a framework to capture the trajectory of COVID-19 disease in patients and their response to interventions.

Original languageEnglish
Article number109
Journalnpj Digital Medicine
Issue number1
Publication statusPublished - Dec 1 2020

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health Informatics
  • Health Information Management
  • Computer Science Applications


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