Journal: Frontiers in Digital Health
Article Title: Guideline-based strategies to identify severe cytokine release syndrome in COVID-19 and cancer immunotherapy using large-scale electronic health records
doi: 10.3389/fdgth.2025.1625889
Figure Lengend Snippet: CRS grading algorithm (decision tree) on EHR datasets following the ASTCT grading guideline. (A) The latest and commonly used ASTCT CRS grading , keeping identical wording as in the original publication. (B) From the list of reported patient features within a time window of 30 days after the triggering event (TCE administration or COVID-19 diagnosis), patients are first graded into ‘grade N+’ and then separated into definite grades: grade 1+ includes patients with fever ≥38 °C (‘strict’ definition) or those with potentially mitigated fever by corticosteroid or cytokine blocker (anti-IL1 or anti-IL6) therapy (‘mitigated’ definition). Grade 2+ to 4+ are defined based on the grade-defining interventions: grade 4+: CPAP or invasive ventilation or use of multiple vasopressors; grade 3+ (one vasopressor or non-CPAP ventilation); and grade 2+ (evidence for hypoxia or hypotension). Notably, we assumed that the use of vasopressors or ventilation indicated hypoxia or hypotension, even if the reported cardiovascular or respiratory parameters were within the reference range. Patients without grade 2+ were classified as “definite” grades if lab values were in range, “probable” grades if hypoxia or hypotension were not measured, or as non-classifiable. We proposed a definition for CRS grade 2+ (or grade 3+) positive and negative (i.e., control) cohorts. SaO2 = arterial oxygen saturation, SBP = systolic blood pressure SpO2 = peripheral oxygen saturation, PaO2 = partial arterial oxygen pressure, PvO2 = venous oxygen tension, and DBP = diastolic blood pressure.
Article Snippet: Using the Optum® de-identified COVID-19 EHR dataset, we isolated 2.5 million patients with active COVID-19 and 171 individuals treated with the T-cell Engager (TCE) blinatumomab.
Techniques: Biomarker Discovery, Control