Characterizing Long COVID: Deep Phenotype of a Complex Condition.

BACKGROUND: Numerous publications describe the clinical manifestations of post-acute sequelae of SARS-CoV-2 (PASC or "long COVID"), but they are difficult to integrate because of heterogeneous methods and the lack of a standard for denoting the many phenotypic manifestations. Patient-led studies are of particular importance for understanding the natural history of COVID-19, but integration is hampered because they often use different terms to describe the same symptom or condition. This significant disparity in patient versus clinical characterization motivated the proposed ontological approach to specifying manifestations, which will improve capture and integration of future long COVID studies. METHODS: The Human Phenotype Ontology (HPO) is a widely used standard for exchange and analysis of phenotypic abnormalities in human disease but has not yet been applied to the analysis of COVID-19. FUNDING: We identified 303 articles published before April 29, 2021, curated 59 relevant manuscripts that described clinical manifestations in 81 cohorts three weeks or more following acute COVID-19, and mapped 287 unique clinical findings to HPO terms. We present layperson synonyms and definitions that can be used to link patient self-report questionnaires to standard medical terminology. Long COVID clinical manifestations are not assessed consistently across studies, and most manifestations have been reported with a wide range of synonyms by different authors. Across at least 10 cohorts, authors reported 31 unique clinical features corresponding to HPO terms; the most commonly reported feature was Fatigue (median 45.1%) and the least commonly reported was Nausea (median 3.9%), but the reported percentages varied widely between studies. INTERPRETATION: Translating long COVID manifestations into computable HPO terms will improve analysis, data capture, and classification of long COVID patients. If researchers, clinicians, and patients share a common language, then studies can be compared/pooled more effectively. Furthermore, mapping lay terminology to HPO will help patients assist clinicians and researchers in creating phenotypic characterizations that are computationally accessible, thereby improving the stratification, diagnosis, and treatment of long COVID. FUNDING: U24TR002306; UL1TR001439; P30AG024832; GBMF4552; R01HG010067; UL1TR002535; K23HL128909; UL1TR002389; K99GM145411.

Assessing the Prevalence of Ahima-Identified Health Informatics and Information Management Careers and Related Skills: A Cross-Sectional Study.

This study's objective was to identify the prevalence of the American Health Information Management Association (AHIMA) career map jobs and determine which job categories, degrees, and skills are associated with higher pay. We extracted data from SimplyHired, a major employment website, from December 2018 to December 2019. We retrieved 12,688 career posts. We found differences in average salary by career category (p-value 0.00). Most jobs were in coding and revenue cycle (CRC) and information governance (IG) categories. The highest average salaries were in data analytics (DA) and informatics (IN). Each career category had a unique set of skills associated with the highest paying jobs. Eighty-two percent of CRC, 67 percent of IG, 65 percent of IN, and 83 percent of DA jobs listed in the AHIMA career map were present in the extracted dataset. These results can help employees, academics, and industry leaders understand the health informatics and information management (HIM) workforce landscape.

Increases in multimorbidity with weight class in the United States.

Little is known regarding how multimorbidity combinations associated with obesity change with increase in body weight. This study employed data from the national Cerner HealthFacts Data Warehouse to identify changes in multimorbidity patterns by weight class using network analysis. Networks were generated for 154 528 middle-aged patients in the following categories: normal weight, overweight, and classes 1, 2, and 3 obesity. The results show significant differences (P-value<0.05) in prevalence by weight class for all but three of 82 diseases considered. The percentage of patients with multimorbidity (excluding obesity) increases from in 55.1% in patients with normal weight, to 57.88% with overweight, 70.39% with Class 1 obesity, 73.99% with Class 2 obesity, and 71.68% in Class 3 obesity, increasing most substantially with the progression from overweight to class 1 obesity. Most prevalent disease clusters expand from only hypertension and dorsalgia in normal weight, to add joint disorders in overweight, lipidemias in class 1 obesity, diabetes in class 2 obesity, and sleep disorders and chronic kidney disease in class 3 obesity. Recognition of multimorbidity patterns associated with weight increase is essential for true precision care of obesity-associated chronic conditions and can help clinicians identify and address preclinical disease before additional complications arise.

The (lack of) impact of retraction on citation networks.

Article retraction in research is rising, yet retracted articles continue to be cited at a disturbing rate. This paper presents an analysis of recent retraction patterns, with a unique emphasis on the role author self-cites play, to assist the scientific community in creating counter-strategies. This was accomplished by examining the following: (1) A categorization of retracted articles more complete than previously published work. (2) The relationship between citation counts and after-retraction self-cites from the authors of the work, and the distribution of self-cites across our retraction categories. (3) The distribution of retractions written by both the author and the editor across our retraction categories. (4) The trends for seven of our nine defined retraction categories over a 6-year period. (5) The average journal impact factor by category, and the relationship between impact factor, author self-cites, and overall citations. Our findings indicate new reasons for retractions have emerged in recent years, and more editors are penning retractions. The rates of increase for retraction varies by category, and there is statistically significant difference of average impact factor between many categories. 18 % of authors self-cite retracted work post retraction with only 10 % of those authors also citing the retraction notice. Further, there is a positive correlation between self-cites and after retraction citations.