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Phenotype 3.0 (deprecated_

empfff edited this page Feb 9, 2021 · 1 revision

COVID-19 Phenotype Documentation, Version 3.0 (Last updated 11/12/2020)

Objective: To identify lab-confirmed, suspected, and possible cases of COVID-19, and demographically match those cases to controls who have tested negative/equivocal for COVID-19, at a ratio of 1:2 (cases:controls).

Note: The phenotype is specifically designed to include criteria that would be queryable in most clinical common data models (CDMs), including OMOP, PCORnet, ACT, and TriNetX. This may not enable inclusion of certain criteria that would otherwise be available (e.g., in a local data warehouse), such as temperature, O2 sat measurements, isolation flags, and information gleaned from clinical notes.

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Changelog (from version 2.2)

  • Asymptomatic controls (patients with a negative/equivocal test and a Z11.59 diagnosis code) have been reintroduced to the pool of potential controls.
  • We are no longer pulling all patients with negative/equivocal tests, but rather a subset. Patients who test negative/equivocal are now matched to positive and presumptive positive cases based on age, sex, race, and ethnicity. Demographically matched controls are randomly sampled until each case has two matching controls.

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Phenotype Inclusion Criteria:

Cases:

  • No age or demographic restrictions.
  • Use 1/1/2020 as the start date.
  • Patient must have:
    • ONE or more of the lab tests in the Labs table (below), with a positive result. (Different institutions use different terms/values for “positive”; see this article for more details.

      OR

    • ONE or more of the “Strong Positive” diagnosis codes from the ICD-10 or SNOMED tables (below)

      OR

    • TWO or more of the “Weak Positive” diagnosis codes from the ICD-10 or SNOMED tables (below) during the same encounter or on the same date, on or prior to 5/1/2020

Controls:

  • No age or demographic restrictions.
  • Use 1/1/2020 as the start date.
  • Patient must have ONE or more of the lab tests in the Labs table (below), with a _non-positive _result.
  • Patient must NOT have qualified as a case.
  • There must be at least 10 days between patient's minimum and maximum encounter date in the EHR. (Eliminates patients who have only been seen for a COVID test.)

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Labs

LOINC Code Name Provenance
94306-8 SARS coronavirus 2 RNA panel, unspecified specimen https://loinc.org/sars-coronavirus-2/
94307-6 SARS-CoV-2 N gene, unspecified specimen https://loinc.org/sars-coronavirus-2/
94308-4 SARS-CoV-2 N gene, unspecified specimen https://loinc.org/sars-coronavirus-2/
94309-2 SARS-CoV-2 RNA, unspecified specimen https://loinc.org/sars-coronavirus-2/
94311-8 SARS-CoV-2 N gene, unspecified specimen https://loinc.org/sars-coronavirus-2/
94312-6 SARS-CoV-2 N gene, unspecified specimen https://loinc.org/sars-coronavirus-2/
94314-2 SARS-CoV-2 RdRp gene, unspecified specimen https://loinc.org/sars-coronavirus-2/
94316-7 SARS-CoV-2 N gene, unspecified specimen https://loinc.org/sars-coronavirus-2/
94500-6 SARS-CoV-2 RNA, respiratory specimen https://loinc.org/sars-coronavirus-2/
94503-0 SARS coronavirus 2 IgG and IgM panel, serum or plasma https://loinc.org/sars-coronavirus-2/
94504-8 SARS coronavirus 2 IgG and IgM panel, serum or plasma https://loinc.org/sars-coronavirus-2/
94505-5 SARS-CoV-2 IgG, serum or plasma https://loinc.org/sars-coronavirus-2/
94506-3 SARS-CoV-2 IgM, serum or plasma https://loinc.org/sars-coronavirus-2/
94507-1 SARS-CoV-2 IgG, serum or plasma https://loinc.org/sars-coronavirus-2/
94508-9 SARS-CoV-2 IgM, serum or plasma https://loinc.org/sars-coronavirus-2/
94510-5 SARS-CoV-2 N gene, unspecified specimen https://loinc.org/sars-coronavirus-2/
94511-3 SARS-CoV-2 ORF1ab region, unspecified specimen https://loinc.org/sars-coronavirus-2/
94531-1 SARS coronavirus 2 RNA panel, respiratory specimen https://loinc.org/sars-coronavirus-2/
94533-7 SARS-CoV-2 N gene, respiratory specimen https://loinc.org/sars-coronavirus-2/
94534-5 SARS-CoV-2 RdRp gene, respiratory specimen https://loinc.org/sars-coronavirus-2/
94547-7 SARS-CoV-2 IgG + IgM, serum or plasma https://loinc.org/sars-coronavirus-2/
94558-4 SARS-CoV-2 Ag, respiratory specimen https://loinc.org/sars-coronavirus-2/
94559-2 SARS-CoV-2 ORF1ab region, respiratory specimen https://loinc.org/sars-coronavirus-2/
94562-6 SARS-CoV-2 IgA, serum or plasma https://loinc.org/sars-coronavirus-2/
94563-4 SARS-CoV-2 IgG, serum or plasma https://loinc.org/sars-coronavirus-2/
94564-2 SARS-CoV-2 IgM, serum or plasma https://loinc.org/sars-coronavirus-2/
94565-9 SARS-CoV-2 RNA, nasopharyngeal specimen https://loinc.org/sars-coronavirus-2/
94639-2 SARS-CoV-2 ORF1ab region, unspecified specimen https://loinc.org/sars-coronavirus-2/
94640-0 SARS-CoV-2 S gene, respiratory specimen https://loinc.org/sars-coronavirus-2/
94641-8 SARS-CoV-2 S gene, unspecified specimen https://loinc.org/sars-coronavirus-2/
94642-6 SARS-CoV-2 S gene, respiratory specimen https://loinc.org/sars-coronavirus-2/
94643-4 SARS-CoV-2 S gene, unspecified specimen https://loinc.org/sars-coronavirus-2/
94644-2 SARS-CoV-2 ORF1ab region, respiratory specimen https://loinc.org/sars-coronavirus-2/
94645-9 SARS-CoV-2 RdRp gene, unspecified specimen https://loinc.org/sars-coronavirus-2/
94646-7 SARS-CoV-2 RdRp gene, respiratory specimen https://loinc.org/sars-coronavirus-2/
94660-8 SARS-CoV-2 RNA, serum/plasma https://loinc.org/sars-coronavirus-2/
94661-6 SARS-CoV-2 antibody interpretation https://loinc.org/sars-coronavirus-2/
94720-0 SARS-CoV-2 IgA, serum or plasma https://loinc.org/sars-coronavirus-2/
94745-7 SARS-CoV-2 RNA, respiratory specimen https://loinc.org/sars-coronavirus-2/
94746-5 SARS-CoV-2 RNA, unspecified specimen https://loinc.org/sars-coronavirus-2/
94756-4 SARS-CoV-2 N gene, respiratory specimen https://loinc.org/sars-coronavirus-2/
94757-2 SARS-CoV-2 N gene, respiratory specimen https://loinc.org/sars-coronavirus-2/
94759-8 SARS-CoV-2 N overall result, nasopharyngeal specimen https://loinc.org/sars-coronavirus-2/
94760-6 SARS-CoV-2 N gene result, nasopharyngeal specimen https://loinc.org/sars-coronavirus-2/
94761-4 SARS-CoV-2 IgG Ab, DBS https://loinc.org/sars-coronavirus-2/
94762-2 SARS-CoV-2 Ab qualitative https://loinc.org/sars-coronavirus-2/
94763-0 SARS-CoV-2, unspecified specimen https://loinc.org/sars-coronavirus-2/
94764-8 SARS-CoV-2 whole genome https://loinc.org/sars-coronavirus-2/
94766-3 SARS-CoV-2 N gene, serum or plasma https://loinc.org/sars-coronavirus-2/
94767-1 SARS-CoV-2 S gene, serum or plasma https://loinc.org/sars-coronavirus-2/
94768-9 SARS-CoV-2 IgA, serum or plasma https://loinc.org/sars-coronavirus-2/
94769-7 SARS-CoV-2 IgA, serum or plasma https://loinc.org/sars-coronavirus-2/
94819-0 SARS-CoV-2 N gene, unspecified specimen https://loinc.org/sars-coronavirus-2/
94822-4 SARS-CoV-2 RNA, saliva https://loinc.org/sars-coronavirus-2/
94845-5 SARS-CoV-2 RNA, saliva https://loinc.org/sars-coronavirus-2/
95125-1 SARS-CoV-2 IgA+IgM, serum or plasma https://loinc.org/sars-coronavirus-2/
95406-5 SARS-CoV-2 RNA, nose https://loinc.org/sars-coronavirus-2/
95409-9 SARS-CoV-2 N gene, nose https://loinc.org/sars-coronavirus-2/
95410-7 SARS-CoV-2 neutralizing antibody, serum https://loinc.org/sars-coronavirus-2/
95411-5 SARS-CoV-2 neutralizing antibody, serum https://loinc.org/sars-coronavirus-2/
95416-4 SARS-CoV-2 IgM Ab, DBS https://loinc.org/sars-coronavirus-2/
95424-8 SARS-CoV-2 RNA, respiratory specimen https://loinc.org/sars-coronavirus-2/
95425-5 SARS-CoV-2 N gene, saliva https://loinc.org/sars-coronavirus-2/
95427-1 SARS-CoV-2 IgA Ab, serum or plasma https://loinc.org/sars-coronavirus-2/
95428-9 SARS-CoV-2 IgM Ab, serum or plasma https://loinc.org/sars-coronavirus-2/
95429-7 SARS-CoV-2 IgG Ab, serum or plasma https://loinc.org/sars-coronavirus-2/
95521-1 SARS-CoV-2 N gene, respiratory specimen https://loinc.org/sars-coronavirus-2/
95522-9 SARS-CoV-2 N gene, respiratory specimen https://loinc.org/sars-coronavirus-2/
NULL* Upper(Name) LIKE ‘%COVID-19%’

*****For non-LOINC-coded covid lab tests at your institution, the string pattern to match in the name may be different then the one shown here. We encourage you to try different combinations per the naming practices at your site (“coronavirus,” “ncov,” “sars-cov,” etc.).

**New LOINCs added in this phenotype version

Diagnosis Codes

ICD-10-CM Code Diagnosis Name Provenance (if known) Confidence Level Notes
B97.21 SARS-associated coronavirus as the cause of diseases classified elsewhere PCORnet Strong positive prior to 4/1/2020; weak positive after 4/1/2020
B97.29 Other coronavirus as the cause of diseases classified elsewhere PCORnet; CDC coding guidance 2/2/2020 Strong positive prior to 4/1/2020; weak positive after 4/1/2020
U07.1 2019-nCoV acute respiratory disease PCORnet slide deck; https://www.who.int/classifications/icd/covid19/en/ Strong positive Code effective as of 4/1/2020
Z11.59 Screening for viral diseases CDC coding guidance 4/1/2020 Asymptomatic Code effective for this purpose as of 4/1/2020 (used to code screenings for other viruses as well, so not extremely specific.)
Z20.828 Contact with and (suspected) exposure to other viral communicable diseases Weak positive Exposure only
B34.2 Coronavirus infection, unspecified Weak positive CDC 2/2/2020 guidance specifically says NOT to use this code; however, likely appears in EHR code “pick lists” for covid
R50.X Fever PCORnet Weak positive
R05.X Cough PCORnet Weak positive
R06.0X Dyspnea PCORnet Weak positive
J12.X; J18.X Pneumonia PCORnet Weak positive
J20.X; J40.X Bronchitis (acute or nonspecified) PCORnet Weak positive
J21.X Acute bronchiolitis PCORnet Weak positive
J96.X Respiratory failure PCORnet Weak positive
J22.X Unspecified acute lower respiratory infection PCORnet Weak positive
J06.9 Acute upper respiratory infection, unspecified PCORnet Weak positive
J98.8 Other specified respiratory disorders PCORnet Weak positive
J80.X Acute respiratory distress syndrome PCORnet Weak positive
R43.0 Anosmia Weak positive
R43.2 Parageusia Weak positive
R07.1 Chest pain on breathing Weak positive
R68.83 Chills (without fever) Weak positive

SNOMED codes

SNOMED Code Name Provenance Confidence Level
840539006 Disease caused by 2019 novel coronavirus (disorder) OHDSI Strong positive
840544004 Suspected disease caused by 2019 novel coronavirus (situation) OHDSI Strong positive
840546002 Exposure to severe acute respiratory syndrome coronavirus 2 (event) NIH VSAC Weak positive
103001002 Feeling feverish (finding) NIH VSAC Weak positive
11833005 Dry cough (finding) NIH VSAC Weak positive
267036007 Dyspnea (finding) NIH VSAC Weak positive
28743005 Productive cough (finding) NIH VSAC Weak positive
36955009 Loss of taste (finding) NIH VSAC Weak positive
426000000 Fever greater than 100.4 Fahrenheit NIH VSAC Weak positive
44169009 Loss of sense of smell (finding) NIH VSAC Weak positive
49727002 Cough (finding) NIH VSAC Weak positive
135883003 Cough with fever (finding) Weak positive
161855003 Complaining of shivering (finding) Weak positive
161939006 Breathless - moderate exertion (finding) Weak positive
161940008 Breathless - mild exertion (finding) Weak positive
161941007 Dyspnea at rest (finding) Weak positive
2237002 Pleuritic pain (finding) Weak positive
23141003 Gasping for breath (finding) Weak positive
247410004 Painful cough (finding) Weak positive
274640006 Fever with chills (finding) Weak positive
274664007 Chest pain on breathing (finding) Weak positive
284523002 Persistent cough (finding) Weak positive
386661006 Fever (finding) Weak positive
409702008 Hyperpyrexia (finding) Weak positive
426976009 Pain provoked by breathing (finding) Weak positive
43724002 Chill (finding) Weak positive
60845006 Dyspnea on exertion (finding) Weak positive
75483001 Breathing painful (finding) Weak positive

OMOP-only codes (“emergency codes” used as placeholders; only applies to OMOP)

OMOP Concept Code Name Provenance/Comment Confidence Level
756029 Measurement of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Respiratory specimen Only count this if used in the measurement table. N/A
756065 Measurement of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Unspecified specimen Only count this if used in the measurement table. N/A
756084 Measurement of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using Nucleic acid amplification technique in Unspecified specimen Only count this if used in the measurement table. N/A
756055 Measurement of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Only count this if used in the measurement table. N/A
756085 Measurement of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using Nucleic acid amplification technique in Respiratory specimen Only count this if used in the measurement table. N/A
756023 Acute bronchitis caused by severe acute respiratory syndrome coronavirus 2 https://github.com/OHDSI/Covid-19/wiki/Release Strong positive
756031 Bronchitis caused by severe acute respiratory syndrome coronavirus 2 https://github.com/OHDSI/Covid-19/wiki/Release Strong positive
756039 Respiratory infection caused by severe acute respiratory syndrome coronavirus 2 https://github.com/OHDSI/Covid-19/wiki/Release Strong positive
756044 Acute respiratory distress syndrome (ARDS) caused by severe acute respiratory syndrome coronavirus 2 https://github.com/OHDSI/Covid-19/wiki/Release Strong positive
756061 Asymptomatic infection caused by severe acute respiratory syndrome coronavirus 2 https://github.com/OHDSI/Covid-19/wiki/Release Strong positive
756081 Infection of lower respiratory tract caused by severe acute respiratory syndrome coronavirus 2 https://github.com/OHDSI/Covid-19/wiki/Release Strong positive
37310285 Pneumonia caused by 2019 novel coronavirus https://github.com/OHDSI/Covid-19/wiki/Release Strong positive