Department of Health Services Policy and Management, University of South Carolina, Columbia, South Carolina, USA
Big Data Health Science Center, University of South Carolina, Columbia, South Carolina, USA.
BMJ Open. 2022 Sep 13;12(9):e067204. doi: 10.1136/bmjopen-2022-067204.
Despite a higher risk of severe COVID-19 disease in individuals with HIV, the interactions between SARS-CoV-2 and HIV infections remain unclear. To delineate these interactions, multicentre Electronic Health Records (EHR) hold existing promise to provide full-spectrum and longitudinal clinical data, demographics and sociobehavioural data at individual level. Presently, a comprehensive EHR-based cohort for the HIV/SARS-CoV-2 coinfection has not been established; EHR integration and data mining methods tailored for studying the coinfection are urgently needed yet remain underdeveloped.
The overarching goal of this exploratory/developmental study is to establish an EHR-based cohort for individuals with HIV/SARS-CoV-2 coinfection and perform 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. We will use a nationwide EHR database in the USA, namely, National COVID Cohort Collaborative (N3C). Ultimately, collected clinical evidence will be implemented and used to pilot test a clinical decision support prototype to assist providers in screening and referral of at-risk patients in real-world clinics.
The study was approved by the institutional review boards at the University of South Carolina (Pro00121828) as non-human subject study. Study findings will be presented at academic conferences and published in peer-reviewed journals. This study will disseminate urgently needed clinical evidence for guiding clinical practice for individuals with the coinfection at Prisma Health, a healthcare system in collaboration.
尽管 HIV 感染者患严重 COVID-19 疾病的风险较高,但 SARS-CoV-2 与 HIV 感染之间的相互作用仍不清楚。为了阐明这些相互作用,多中心电子健康记录 (EHR) 有望提供全谱和纵向临床数据、人口统计学和社会行为数据。目前,尚未建立针对 HIV/SARS-CoV-2 合并感染的综合 EHR 队列;迫切需要针对该合并感染进行 EHR 整合和数据挖掘的方法,但这些方法仍在开发中。
这项探索性/开发性研究的总体目标是建立一个基于 EHR 的 HIV/SARS-CoV-2 合并感染患者队列,并进行大规模的基于 EHR 的数据挖掘,以研究 HIV 和 SARS-CoV-2 感染之间的相互作用,并系统地识别和验证导致合并感染严重临床病程的因素。我们将使用美国的一个全国性 EHR 数据库,即国家 COVID 队列协作 (N3C)。最终,收集的临床证据将被实施并用于试点测试一个临床决策支持原型,以帮助提供者在真实诊所中对高危患者进行筛查和转诊。
该研究已获得南卡罗来纳大学机构审查委员会的批准(Pro00121828),作为非人类研究。研究结果将在学术会议上进行展示,并发表在同行评议的期刊上。这项研究将为 Prisma Health 合作的医疗系统中合并感染的患者提供急需的临床证据,以指导临床实践。