Evidence map›Paper›PMID 40918941›Full record

ArticleJAMIA open2025

A natural language processing pipeline for identifying pediatric long COVID symptoms and functional impacts in freeform clinical notes: a RECOVER study.

H Timothy Bunnell, Cara Reedy, Vitaly Lorman, Ravi Jhaveri, Andrea Rivera-Sepulveda, Katherine S Salamon, Payal B Patel, Keith E Morse, Mattina A Davenport, Lindsay G Cowell and 13 more

Abstract read
In one paragraph

Article in JAMIA open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

H Timothy BunnellBiomedical Research Informatics Center, Nemours Children's Health, Wilmington, DE 19803, United States.
Cara ReedyBiomedical Research Informatics Center, Nemours Children's Health, Wilmington, DE 19803, United States.
Vitaly LormanApplied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States.
Ravi JhaveriDivision of Infectious Diseases, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, United States.ORCID https://orcid.org/0000-0001-9921-0419
Andrea Rivera-SepulvedaDivision of Emergency Medicine and Urgent Care, Nemours Children's Health, Orlando, FL 32867, United States.
Katherine S SalamonDepartment of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Menlo Park, CA 94025, United States.ORCID https://orcid.org/0000-0003-0372-7670
Payal B PatelDepartment of Neurology, Seattle Children's Hospital, Seattle, WA 98105, United States.
Keith E MorseDepartment of Pediatrics, Stanford University, Palo Alto, CA 94305, United States.
Mattina A DavenportCenter for Child Health Equity and Outcomes Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, United States.
Lindsay G CowellDepartment of Health Data Science and Biostatistics, O'Donnell School of Public Health, UT Southwestern Medical Center, Dallas, TX 75390, United States.
Levon UtidjianApplied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States.ORCID https://orcid.org/0000-0002-2189-108X
Dimitri A ChristakisCenter for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA 98105, United States.
Suchitra RaoDepartment of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO 80045, United States.ORCID https://orcid.org/0000-0002-0334-6301
Marion R SillsDepartment of Research, OCHIN Inc, Portland, OR 97228, United States.
Abigail CaseDepartment of Pediatrics and Rehabilitation Medicine, University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States.
Eneida A MendoncaDivision of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States.ORCID https://orcid.org/0000-0003-4297-9221
Bradley W TaylorClinical and Translational Science Institute, The Medical College of Wisconsin, Milwaukee, WI 53226, United States.
Jacqueline RutterRECOVER Patient, Caregiver, or Community Advocate Representative, New York, NY 10012, United States.
Aaron Thomas MartinezRECOVER Patient, Caregiver, or Community Advocate Representative, New York, NY 10012, United States.
Rebecca LettsRECOVER Patient, Caregiver, or Community Advocate Representative, New York, NY 10012, United States.
L Charles BaileyApplied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States.
Christopher B ForrestApplied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States.ORCID https://orcid.org/0000-0003-1252-068X
RECOVER Consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To develop a natural language processing (NLP) pipeline for unstructured electronic health record (EHR) data to identify symptoms and functional impacts associated with Long COVID in children. Materials and Methods: We analyzed 48 287 outpatient progress notes from 10 618 pediatric patients from 12 institutions. We evaluated notes obtained 28 to 179 days after a COVID-19 diagnosis or positive test. Two samples were examined: patients with evidence of Long COVID and patients with acute COVID but no evidence of Long COVID based on diagnostic codes. The pipeline identified clinical concepts associated with 21 symptoms and 4 functional impact categories. Subject matter experts (SMEs) screened a sample of 4586 terms from the NLP output to assess pipeline accuracy. Prevalence and concordance of each of the 25 concepts was compared between the 2 patient samples. Results: A binary assertion measure comparing SME and NLP assertions showed moderate accuracy (N = 4133; F1 = .80) and improved substantially when only high-confidence SME assertions were considered (N = 2043; F1 = .90). Overall, the 25 Long COVID concept categories were markedly more prevalent in the presumptive Long COVID cohort, and differences were noted between concepts identified in notes versus structured data. Discussion: This preliminary analysis illustrates the additional insight into a syndrome such as Long COVID gained from incorporating notes data, characterizing symptoms and functional impacts. Conclusion: These data support the importance of incorporating NLP methodology when possible into designing computable phenotypes and to accurately characterize patients with Long COVID.

Indexed as

NLPpediatricsPEDSnetRECOVER

Identifiers

PMID40918941
PMCPMC12409404

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.