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

Brat GA, Weber GM, Gehlenborg N, Avillach P, Palmer NP, Chiovato L, Cimino J, Waitman LR, Omenn GS, Malovini A, Moore JH, Beaulieu-Jones BK, Tibollo V, Murphy SN, Yi SL, Keller MS, Bellazzi R, Hanauer DA, Serret-Larmande A, Gutierrez-Sacristan A, Holmes JJ, Bell DS, Mandl KD, Follett RW, Klann JG, Murad DA, Scudeller L, Bucalo M, Kirchoff K, Craig J, Obeid J, Jouhet V, Griffier R, Cossin S, Moal B, Patel LP, Bellasi A, Prokosch HU, Kraska D, Sliz P, Tan AL, Ngiam KY, Zambelli A, Mowery DL, Schiver E, Devkota B, Bradford RL, Daniar M, Daniel C, Benoit V, Bey R, Paris N, Serre P, Orlova N, Dubiel J, Hilka M, Jannot AS, Breant S, Leblanc J, Griffon N, Burgun A, Bernaux M, Sandrin A, Salamanca E, Cormont S, Ganslandt T, Gradinger T, Champ J, Boeker M, Martel P, Esteve L, Gramfort A, Grisel O, Leprovost D, Moreau T, Varoquaux G, Vie JJ, Wassermann D, Mensch A, Caucheteux C, Haverkamp C, Lemaitre G, Bosari S, Krantz ID, South A, Cai T, Kohane IS (2020)

Publication Type: Journal article

Publication year: 2020


Book Volume: 3

Article Number: 109

Journal Issue: 1

DOI: 10.1038/s41746-020-00308-0


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.

Authors with CRIS profile

Involved external institutions

Assistance Publique-Hôpitaux de Paris (AP-HP) FR France (FR) Veterans Affairs Healthcare System Boston and Harvard Medical School US United States (USA) (US) Massachusetts General Hospital US United States (USA) (US) University of North Carolina at Chapel Hill US United States (USA) (US) École Polytechnique - Université Paris-Saclay FR France (FR) Istituti Clinici Scientifici (ICS) Maugeri Spa IT Italy (IT) École Normale Supérieure - PSL (ENS) FR France (FR) Ruprecht-Karls-Universität Heidelberg DE Germany (DE) University of Kansas Medical Center US United States (USA) (US) University of California Los Angeles (UCLA) US United States (USA) (US) BIOMEdical Research Informatics Solutions IT Italy (IT) Boston Children's Hospital US United States (USA) (US) Centre Hospitalier Universitaire de Bordeaux / CHU Bordeaux FR France (FR) Perelman School of Medicine University of Pennsylvania US United States (USA) (US) Medical University of South Carolina (MUSC) US United States (USA) (US) Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico IT Italy (IT) University of Michigan US United States (USA) (US) Children's Hospital of Philadelphia US United States (USA) (US) National University of Singapore (NUS) SG Singapore (SG) Azienda Ospedaliera Papa Giovanni XXIII IT Italy (IT) Wake Forest School of Medicine US United States (USA) (US) University of Alabama at Birmingham (UAB) US United States (USA) (US) Albert-Ludwigs-Universität Freiburg DE Germany (DE) University of Montpellier / Université Montpellier FR France (FR) Clevy FR France (FR) Penn Medicine US United States (USA) (US)

How to cite


Brat, G.A., Weber, G.M., Gehlenborg, N., Avillach, P., Palmer, N.P., Chiovato, L.,... Kohane, I.S. (2020). International electronic health record-derived COVID-19 clinical course profiles: the 4CE consortium. npj Digital Medicine, 3(1).


Brat, Gabriel A., et al. "International electronic health record-derived COVID-19 clinical course profiles: the 4CE consortium." npj Digital Medicine 3.1 (2020).

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