Understanding gaps in guideline-recommended adult congenital heart disease care: Data from 12 US health care centers.

Background: Guidelines recommend lifelong care with adult congenital heart disease (ACHD) specialists for adults with congenital heart disease (CHD). However, such gaps in visits at specialized ACHD centers have not been well-characterized from diverse US settings.

Methods: This retrospective study analyzed data from 12 centers in the national Patient-Centered Clinical Research Network.

Impact of Adult Congenital Heart Disease Specialist Visits on Emergent Admissions: Evidence for Guidelines.

Background: Although routine outpatient visits with adult congenital heart defect (ACHD) specialists have been recommended, the evidence to support this remains sparse.

Objectives: The purpose of this study was to evaluate the association between outpatient ACHD visits and emergent admissions.

Methods: This observational study used standardized electronic health record data from 13 health centers from January 1, 2015 through December 31, 2019.

Concordance Between Survey and Electronic Health Record Data in the COVID-19 Citizen Science Study: Retrospective Cohort Analysis.

Background: Real-world data reported by patients and extracted from electronic health records (EHRs) are increasingly leveraged for research, policy, and clinical decision-making. However, it is not always obvious the extent to which these 2 data sources agree with each other.

Objective: This study aimed to evaluate the concordance of variables reported by participants enrolled in an electronic cohort study and data available in their EHRs.

Improvements in micelle promoted DNA-encoded library synthesis by surfactant optimisation.

DNA-encoded libraries are increasingly important in hit identification at the early stage of the drug discovery process. The approach relies on efficient methods for synthesis of drug-like compounds attached to coding DNA sequences. Many reactions employed for library synthesis are inefficient and result in significant DNA-damage, incomplete conversion and the formation of side products, which compromise the fidelity of the resulting library.

The Effect of Probiotics on Health in Pregnancy and Infants: A Randomized, Double-Blind, Placebo-Controlled Trial.

There is growing interest in the benefits of probiotic supplementation during pregnancy and lactation, but evidence supporting the beneficial effects for mother-infant dyads remains scarce. This study assessed the effects of probiotic supplementation on infection frequency and immunity in pregnant women and infants, and on microbiome establishment during the first month of life. At 28 weeks of gestation, 180 healthy pregnant women were randomized to receive either a placebo ( = 90) or a probiotic supplement ( = 90), Prenatis™, containing 5 billion CFU/day of Rosell-11 and HA-132.

HIV Infection and Long COVID: A RECOVER Program, Electronic Health Record Based Cohort Study.

People with HIV may be at increased risk for long COVID after acute SARS-CoV-2 infection. We investigated the association between HIV and long COVID in two large electronic health record databases. Using data from the Patient-Centered Clinical Research Network (PCORnet) and the National Clinical Cohort Collaborative (N3C) from 1/1/2018 to 4/30/2024, our analytic sample included individuals aged ≥21 years with SARS-CoV-2.

County-Level COVID-19 Policy Comprehensiveness and Adult Behavioral Health during 2021 : County-Level COVID-19 Policy and Adult Behavioral Health.

Epidemiologic research has found worsening behavioral health in the USA since 2020. Local policies may have contributed to these patterns and associated disparities. However, scant research has systematically documented county-level COVID-19-era policymaking or empirically investigated its health impacts.

Long COVID after SARS-CoV-2 during pregnancy in the United States.

Pregnancy alters immune responses and clinical manifestations of COVID-19, but its impact on Long COVID remains uncertain. This study investigated Long COVID risk in individuals with SARS-CoV-2 infection during pregnancy compared to reproductive-age females infected outside of pregnancy. A retrospective analysis of two U.

Opportunities and Challenges in Using Electronic Health Record Systems to Study Postacute Sequelae of SARS-CoV-2 Infection: Insights From the NIH RECOVER Initiative.

The benefits and challenges of electronic health records (EHRs) as data sources for clinical and epidemiologic research have been well described. However, several factors are important to consider when using EHR data to study novel, emerging, and multifaceted conditions such as postacute sequelae of SARS-CoV-2 infection or long COVID. In this article, we present opportunities and challenges of using EHR data to improve our understanding of long COVID, based on lessons learned from the National Institutes of Health (NIH)-funded RECOVER (REsearching COVID to Enhance Recovery) Initiative, and suggest steps to maximize the usefulness of EHR data when performing long COVID research.

Associations between local COVID-19 policies and anxiety in the USA: a longitudinal digital cohort study.

Introduction: A lack of coordinated federal guidance led to substantial heterogeneity in local COVID-19 policies across US states and counties. Local government policies may have contributed to increases in anxiety and mental health disparities during the COVID-19 pandemic.

Methods: We analysed associations between composite policy scores for containment and closure, public health or economic support from the US COVID-19 County Policy Database and self-reported anxiety scores (Generalised Anxiety Disorder-7) from COVID-19 Citizen Science participants between 22 April 2020 and 31 December 2021.

Long COVID Incidence Proportion in Adults and Children Between 2020 and 2024: An Electronic Health Record-Based Study From the RECOVER Initiative.

Background: Incidence estimates of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, also known as long COVID, have varied across studies and changed over time. We estimated long COVID incidence among adult and pediatric populations in 3 nationwide research networks of electronic health records (EHRs) participating in the RECOVER (Researching COVID to Enhance Recovery) Initiative using different classification algorithms (computable phenotypes).

Methods: This EHR-based retrospective cohort study included adult and pediatric patients with documented acute SARS-CoV-2 infection and 2 control groups: contemporary coronavirus disease 2019 (COVID-19)-negative and historical patients (2019).

Weighted EHR-based prevalence estimates for hypertension at the state and local levels in Louisiana.

Background: Modernization of public health data systems is a national priority. Improved chronic disease surveillance can provide more timely, accurate, and local measures to inform public health policy and intervention. Although electronic health record (EHR) data have great potential for surveillance, population coverage is non-random, which may result in biased estimates.

Trajectories and patterns of US counties' policy responses to the COVID-19 pandemic: A sequence analysis approach.

Background: It is increasingly recognized that policies played a role in mitigating or exacerbating health inequities during the COVID-19 pandemic. While US counties were particularly active in policymaking, limited work has characterized geographic and temporal variation in pandemic-era policymaking at the local level, a prerequisite for later studies examining the health effects of these policies. This paper fills this gap by characterizing county-level COVID-19-related policy trajectories over time using a novel national policy database and innovative methods.

Four-year follow-up of weight loss maintenance using electronic medical record data: The PROPEL trial.

Rationale: Short-term weight loss is possible in a variety of settings. However, long-term, free-living weight loss maintenance following structured weight loss interventions remains elusive.

Objective: The purpose was to study body weight trajectories over 2 years of intensive lifestyle intervention (ILI) and up to 4 years of follow-up versus usual care (UC).

Patient-Reported Outcomes Among Adults With Congenital Heart Disease in the Congenital Heart Initiative Registry.

Importance: In the US, there are more than 1.5 million adults living with congenital heart disease (CHD). The Congenital Heart Initiative (CHI) is a digital, online, patient-empowered registry that was created to advance multicenter research and improve clinical care by gathering patient-reported outcomes (PROs) in adults with CHD.

Identification of risk factors of Long COVID and predictive modeling in the RECOVER EHR cohorts.

Background: SARS-CoV-2-infected patients may develop new conditions in the period after the acute infection. These conditions, the post-acute sequelae of SARS-CoV-2 infection (PASC, or Long COVID), involve a diverse set of organ systems. Limited studies have investigated the predictability of Long COVID development and its associated risk factors.

Preventive Service Usage and New Chronic Disease Diagnoses: Using PCORnet Data to Identify Emerging Trends, United States, 2018-2022.

Background: Data modernization efforts to strengthen surveillance capacity could help assess trends in use of preventive services and diagnoses of new chronic disease during the COVID-19 pandemic, which broadly disrupted health care access.

Methods: This cross-sectional study examined electronic health record data from US adults aged 21 to 79 years in a large national research network (PCORnet), to describe use of 8 preventive health services (N = 30,783,825 patients) and new diagnoses of 9 chronic diseases (N = 31,588,222 patients) during 2018 through 2022. Joinpoint regression assessed significant trends, and health debt was calculated comparing 2020 through 2022 volume to prepandemic (2018 and 2019) levels.

Real-World Effectiveness of Nirmatrelvir in Protecting Long COVID for Outpatient Adult Patients - A Large-Scale Observational Cohort Study from the RECOVER Initiative.

Paxlovid has been approved for use in patients who are at high risk for severe acute COVID-19 illness. Evidence regarding whether Paxlovid protects against Post-Acute Sequelae of SARS-CoV-2 infection (PASC), or Long COVID, is mixed in high-risk patients and lacking in low-risk patients. With a target trial emulation framework, we evaluated the association of Paxlovid treatment within 5 days of SARS-CoV-2 infection with incident Long COVID and hospitalization or death from any cause in the post-acute period (30-180 days after infection) using electronic health records from the Patient-Centered Clinical Research Networks (PCORnet) RECOVER repository.

Association between acquiring SARS-CoV-2 during pregnancy and post-acute sequelae of SARS-CoV-2 infection: RECOVER electronic health record cohort analysis.

Background: Little is known about post-acute sequelae of SARS-CoV-2 infection (PASC) after acquiring SARS-CoV-2 infection during pregnancy. We aimed to evaluate the association between acquiring SARS-CoV-2 during pregnancy compared with acquiring SARS-CoV-2 outside of pregnancy and the development of PASC.

Methods: This retrospective cohort study from the Researching COVID to Enhance Recovery (RECOVER) Initiative Patient-Centred Clinical Research Network (PCORnet) used electronic health record (EHR) data from 19 U.

Long COVID incidence in adults and children between 2020 and 2023: a real-world data study from the RECOVER Initiative.

Estimates of post-acute sequelae of SARS-CoV-2 infection (PASC) incidence, also known as Long COVID, have varied across studies and changed over time. We estimated PASC incidence among adult and pediatric populations in three nationwide research networks of electronic health records (EHR) participating in the RECOVER Initiative using different classification algorithms (computable phenotypes). Overall, 7% of children and 8.

EFFECT OF PAXLOVID TREATMENT DURING ACUTE COVID-19 ON LONG COVID ONSET: AN EHR-BASED TARGET TRIAL EMULATION FROM THE N3C AND RECOVER CONSORTIA.

Background: Preventing and treating post-acute sequelae of SARS-CoV-2 infection (PASC), commonly known as Long COVID, has become a public health priority. Researchers have begun to explore whether Paxlovid treatment in the acute phase of COVID-19 could help prevent the onset of PASC.

Methods And Findings: We used electronic health records from the National Clinical Cohort Collaborative (N3C) to define a cohort of 410,026 patients who had COVID-19 since April 1, 2022, and were eligible for Paxlovid treatment due to risk for progression to severe COVID-19.

Association between SARS-CoV-2 infection and select symptoms and conditions 31 to 150 days after testing among children and adults.

Background: An increasing number of studies have described new and persistent symptoms and conditions as potential post-acute sequelae of SARS-CoV-2 infection (PASC). However, it remains unclear whether certain symptoms or conditions occur more frequently among persons with SARS-CoV-2 infection compared with those never infected with SARS-CoV-2. We compared the occurrence of specific COVID-associated symptoms and conditions as potential PASC 31- to 150-day following a SARS-CoV-2 test among adults and children with positive and negative test results.