Using the COVID EHR Cohort at the University of Wisconsin (CEC-UW), this project aimed to analyze the disproportionate impact of COVID-19 on racial and ethnic minority groups in Wisconsin, compare disease outcomes between UW Health and other health systems and test associations between risk factors, treatments and vaccine status with disease outcomes. CEC-UW has been collecting electronic health record (EHR) data from all COVID-19 patients across 21 participating health systems and, as of September 2021, has compiled more than 250 EHR elements from 1.1 million COVID-19 patients. This data has the potential to help target high-risk individuals, improve treatment, guide variant management and enhance response to future disease outbreaks.
The results revealed that Black and Hispanic communities, along with low-income groups, faced significantly higher infection rates and more severe COVID-19 outcomes. Comparison of outcomes between health systems showed that UW Health patients had better recovery rates and lower mortality due to more effective health strategies, including advanced treatment protocols and higher vaccination rates. Finally, the project found that early treatments and full vaccination greatly improved outcomes, while those with underlying conditions or lack of vaccine access faced worse outcomes.
The Challenge
As of September 2021, the COVID EHR Cohort at the University of Wisconsin (CEC-UW), a project collecting electronic health record (EHR) data from all COVID-19 patients across 21 participating health systems, had compiled more than 250 EHR elements from 1.1 million COVID patients, making it one of the two largest COVID data sets in the world. EHR elements included patient demographic information, medical comorbidities, lab tests, medications, COVID treatments, vaccination status and outcomes. This data, specific to Wisconsin, has the potential to enhance the targeting of individuals at greatest risk, inform treatment of future patients, offer guidance for managing the evolution of variants like Omicron and provide insights to improve the monitoring and treatment of future novel disease outbreaks in Wisconsin.
Project Goals
This project had four primary objectives. First, it sought to analyze data and investigate the disproportionate impact of COVID-19 on racial and ethnic minority groups, as well as vulnerable populations in Wisconsin. Second, the project team aimed to compare COVID-19 outcomes between patients at UW Health and those at the other 20 health systems. Third, it would test the associations between various risk factors, treatments and vaccine statuses with disease outcomes. Finally, this project planned to provide pilot funding to five UW investigators to use the data to pursue innovative projects that addressed COVID-19 in the state and across the country.
Results
The project achieved each of its objectives. The analysis revealed that Black and Hispanic communities, along with low-income groups, experienced significantly higher infection rates and more severe health outcomes compared to their white and higher-income counterparts. These findings underscored the critical need for targeted public health interventions to address these disparities, such as increasing access to health care and providing culturally tailored health education.
In comparing COVID-19 outcomes between UW Health and 20 other health systems, results indicated that UW health patients had better recovery and lower mortality rates. These differences were attributed to more effective health care strategies at UW Health, including early adoption of advanced treatment protocols and a higher rate of vaccination among their patients.
Finally, the project examined the relationships between specific risk factors, treatments and vaccine statuses with COVID-19 outcomes both in Wisconsin and across the nation. It found that early intervention with treatments like monoclonal antibodies and antivirals significantly improved patient recovery and survival rates. Patients who were fully vaccinated had much better outcomes, even if they contracted the virus. Conversely, individuals with underlying health conditions, like diabetes and heart disease, or those who lacked access to vaccines, faced worse outcomes.
