Understanding temporal dynamics of COVID-19 patient symptoms could provide fine-grained resolution to guide clinical decision-making. Here, we use deep neural networks over an institution-wide platform for the augmented curation of clinical notes from 77,167 patients subjected to COVID-19 PCR testing. By contrasting Electronic Health Record (EHR)-derived symptoms of COVID-19-positive (COVIDpos; n=2,317) versus COVID-19-negative (COVIDneg; n=74,850) patients for the week preceding the PCR testing date, we identify anosmia/dysgeusia (27.1-fold), fever/chills (2.6-fold), respiratory difficulty (2.2-fold), cough (2.2-fold), myalgia/arthralgia (2-fold), and diarrhea (1.4-fold) as significantly amplified in COVIDpos over COVIDneg patients. The combination of cough and fever/chills has 4.2-fold amplification in COVIDpos patients during the week prior to PCR testing, and along with anosmia/dysgeusia, constitutes the earliest EHR-derived signature of COVID-19. This study introduces an Augmented Intelligence platform for the real-time synthesis of institutional biomedical knowledge. The platform holds tremendous potential for scaling up curation throughput, thus enabling EHR-powered early disease diagnosis.
The EHR dataset where augmented curation was conducted from the Mayo Clinic records was accessed under IRB 20-003278, "Study of COVID-19 patient characteristics with augmented curation of Electronic Health Records (EHR) to inform strategic and operational decisions". The EHR data cannot be shared or released due to HIPAA regulations. Contact corresponding authors for additional details regarding the IRB, and please refer to the Mayo Clinic IRB website for further details on our commitment to patient privacy (https://www.mayo.edu/research/institutional-review-board/overview). The summary statistics derived from the EHRs are enclosed within the manuscript.
- Andrew Badley, MD
- Andrew Badley, MD
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Human subjects: This research was conducted under IRB 20-003278, "Study of COVID-19 patient characteristics with augmented curation of Electronic Health Records (EHR) to inform strategic and operational decisions". All analysis of EHRs was performed in the privacy-preserving environment secured and controlled by the Mayo Clinic. nference and the Mayo Clinic subscribe to the basic ethical principles underlying the conduct of research involving human subjects as set forth in the Belmont Report and strictly ensures compliance with the Common Rule in the Code of Federal Regulations (45 CFR 46) on Protection of Human Subjects. Please refer to the Mayo Clinic IRB website for further information - https://www.mayo.edu/research/institutional-review-board/overview
- Frank L van de Veerdonk, Radboud University Medical Center, Netherlands
© 2020, Wagner et al.
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