International Changes in COVID-19 Clinical Trajectories Across 315 Hospitals and 6 Countries: Retrospective Cohort Study

Griffin M Weber   ^{1 *} , MD, PhD ;   Harrison G Zhang   ^{1 *} , HSDG ;   Sehi L'Yi   ^{1 *} , PhD ;   Clara-Lea Bonzel   ¹ , MSc ;   Chuan Hong   ¹ , PhD ;   Paul Avillach   ¹ , MD, PhD ;   Alba Gutiérrez-Sacristán   ¹ , PhD ;   Nathan P Palmer   ¹ , PhD ;   Amelia Li Min Tan   ¹ , BSc, PhD ;   Xuan Wang   ¹ , PhD ;   William Yuan   ¹ , PhD ;   Nils Gehlenborg   ¹ , PhD ;   Anna Alloni   ² , PhD ;   Danilo F Amendola   ³ , MSc ;   Antonio Bellasi   ⁴ , MD, PhD ;   Riccardo Bellazzi   ⁵ , MS, PhD ;   Michele Beraghi   ⁶ , MS ;   Mauro Bucalo   ² , MS ;   Luca Chiovato   ⁷ , MD, PhD ;   Kelly Cho   ⁸ , PhD ;   Arianna Dagliati   ⁹ , MS, PhD ;   Hossein Estiri   ¹⁰ , PhD ;   Robert W Follett   ¹¹ , BS ;   Noelia García Barrio   ¹² , MS ;   David A Hanauer   ¹³ , MS, MD ;   Darren W Henderson   ¹⁴ , BS ;   Yuk-Lam Ho   ⁸ , MPH ;   John H Holmes   ^{15, 16} , MS, PhD ;   Meghan R Hutch   ¹⁷ , BS ;   Ramakanth Kavuluru   ¹⁸ , PhD ;   Katie Kirchoff   ¹⁹ , MSHI ;   Jeffrey G Klann   ¹⁰ , MEng, PhD ;   Ashok K Krishnamurthy   ²⁰ , PhD ;   Trang T Le   ¹⁵ , PhD ;   Molei Liu   ²¹ , MSc ;   Ne Hooi Will Loh   ²² , MBBS ;   Sara Lozano-Zahonero   ²³ , PhD ;   Yuan Luo   ¹⁷ , PhD ;   Sarah Maidlow   ²⁴ , AA ;   Adeline Makoudjou   ²³ , MD ;   Alberto Malovini   ²⁵ , PhD ;   Marcelo Roberto Martins   ²⁶ , MSc ;   Bertrand Moal   ²⁷ , MD, PhD ;   Michele Morris   ²⁸ , BA ;   Danielle L Mowery   ¹⁵ , PhD ;   Shawn N Murphy   ²⁹ , MD, PhD ;   Antoine Neuraz   ³⁰ , MD, PhD ;   Kee Yuan Ngiam   ³¹ , MBBS, MRCS, MMed ;   Marina P Okoshi   ³² , MD, PhD ;   Gilbert S Omenn   ³³ , MD, PhD ;   Lav P Patel   ³⁴ , MS ;   Miguel Pedrera Jiménez   ¹² , MS ;   Robson A Prudente   ³² , PhD ;   Malarkodi Jebathilagam Samayamuthu   ²⁸ , MD ;   Fernando J Sanz Vidorreta   ¹¹ , BS ;   Emily R Schriver   ³⁵ , MS ;   Petra Schubert   ⁸ , MPH ;   Pablo Serrano Balazote   ¹² , MS, MD ;   Byorn WL Tan   ³⁶ , MBBS ;   Suzana E Tanni   ³² , MD, PhD ;   Valentina Tibollo   ²⁵ , MS ;   Shyam Visweswaran   ²⁸ , MD, PhD ;   Kavishwar B Wagholikar   ¹⁰ , MBBS, PhD ;   Zongqi Xia   ³⁷ , MD, PhD ;   Daniela Zöller   ²³ , PhD ;   The Consortium For Clinical Characterization Of COVID-19 By EHR (4CE)   ¹ ;   Isaac S Kohane   ¹ , MD, PhD ;   Tianxi Cai   ^{1 *} , ScD ;   Andrew M South   ^{38 *} , MS, MD ;   Gabriel A Brat   ^{1 *} , MPH, MD

¹ Department of Biomedical Informatics, Harvard Medical School, Boston, MA, United States

² BIOMERIS (BIOMedical Research Informatics Solutions), Pavia, Italy

³ Clinical Research Unit, Botucatu Medical School, São Paulo State University, Botucatu, Brazil

⁴ Division of Nephrology, Department of Medicine, Ente Ospedaliero Cantonale, Lugano, Switzerland

⁵ Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy

⁶ Information Technology Department, Azienda Socio-Sanitaria Territoriale di Pavia, Pavia, Italy

⁷ Unit of Internal Medicine and Endocrinology, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Italy

⁸ Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System, Boston, MA, United States

⁹ Department of Electrical Computer and Biomedical Engineering, University of Pavia, Pavia, Italy

¹⁰ Department of Medicine, Massachusetts General Hospital, Boston, MA, United States

¹¹ Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States

¹² Health Informatics, Hospital Universitario 12 de Octubre, Madrid, Spain

¹³ Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, United States

¹⁴ Department of Biomedical Informatics, University of Kentucky, Lexington, KY, United States

¹⁵ Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States

¹⁶ Institute for Biomedical Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States

¹⁷ Department of Preventive Medicine, Northwestern University, Chicago, IL, United States

¹⁸ Institute for Biomedical Informatics, University of Kentucky, Lexington, KY, United States

¹⁹ Medical University of South Carolina, Charleston, SC, United States

²⁰ Department of Computer Science, Renaissance Computing Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States

²¹ Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States

²² Department of Anaesthesia, National University Health System, Singapore, Singapore

²³ Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany

²⁴ Michigan Institute for Clinical & Health Research Informatics, University of Michigan, Ann Arbor, MI, United States

²⁵ Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Italy

²⁶ Clinical Hospital of Botucatu Medical School, São Paulo State University, Botucatu, Brazil

²⁷ Informatique et archivistique médicales unit, Bordeaux University Hospital, Bordeaux, France

²⁸ Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States

²⁹ Department of Neurology, Massachusetts General Hospital, Boston, MA, United States

³⁰ Department of Biomedical Informatics, Hôpital Necker-Enfants Malade, Assistance Publique Hôpitaux de Paris, University of Paris, Paris, France

³¹ Department of Biomedical Informatics, Institute for Digital Medicine, National University Health System, Singapore, Singapore

³² Internal Medicine Department, Botucatu Medical School, São Paulo State University, Botucatu, Brazil

³³ Department of Computational Medicine & Bioinformatics, Internal Medicine, Human Genetics, and Public Health, University of Michigan, Ann Arbor, MI, United States

³⁴ Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States

³⁵ Data Analytics Center, University of Pennsylvania Health System, Philadelphia, PA, United States

³⁶ Department of Medicine, National University Health System, Singapore, Singapore

³⁷ Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States

³⁸ Section of Nephrology, Department of Pediatrics, Brenner Children's Hospital, Wake Forest School of Medicine, Winston Salem, NC, United States

*these authors contributed equally