Temporal inference from laboratory testing results and triangulation with clinical outcomes extracted from unstructured EHR provider notes is integral to advancing precision medicine. Here, we studied 246 SARS-CoV-2 PCR-positive (COVIDpos)patients and propensity-matched 2,460 SARS-CoV-2 PCR-negative (COVIDneg) patients subjected to around 700,000 lab tests cumulatively across 194 assays. Compared to COVIDneg patients at the time of diagnostic testing, COVIDpos patients tended to have higher plasma fibrinogen levels and lower platelet counts. However, as the infection evolves, COVIDpos patients distinctively show declining fibrinogen, increasing platelet counts, and lower white blood cell counts. Augmented curation of EHRs suggests that only a minority of COVIDpos patients develop thromboembolism, and rarely, disseminated intravascular coagulopathy (DIC), with patients generally not displaying platelet reductions typical of consumptive coagulopathies. These temporal trends provide fine-grained resolution into COVID-19 associated coagulopathy (CAC) and set the stage for personalizing thromboprophylaxis.
De-identified data will be made available upon reasonable request to the corresponding author (Venky Soundararajan, email@example.com).
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, the Mayo Clinic, and the Janssen pharmaceutical companies of Johnson & Johnson (J&J) subscribe to the basic ethical principles underlying the conduct of research involving human subjects as set forth in the Belmont Report and strictly ensure compliance with the Common Rule in the Code of Federal Regulations (45 CFR 46) on the Protection of Human Subjects.
- Frank L van de Veerdonk, Radboud University Medical Center, Netherlands
© 2020, Pawlowski et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
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