COVID-19: What’s in a Name?
Early in the current coronavirus outbreak, the disease was referred to as “2019 novel coronavirus.” This referred to the fact that this particular coronavirus had not been seen in humans before 2019. Subsequently, the World Health Organization, which is responsible for naming new diseases, named the disease COronaVIrus Disease 2019 (COVID-19). This caused some confusion in the press as articles have referred to the virus as COVID-19. However, the International Committee on Taxonomy of Viruses, responsible for classifying and naming viruses, has named the coronavirus which causes COVID-19 as Severe Acute Respiratory Syndrome-related coronavirus 2 or SARS-related CoV-2 (SARS-CoV-2).
The “2” results from this virus being of the same species of virus as the coronavirus causing the outbreak of SARS in 2003. SARS-CoV-2 belongs to the same coronavirus species, but is distinct from the virus identified in 2003. SARS-CoV-2 causes a similar illness, but importantly is seen as a different virus by our immune system and by tests that can detect the virus particles.
Having an official name for the virus and the disease it causes is an important first step. But enabling interoperability so that we can leverage health information technology and electronic data to help us with the challenges of care delivery, care coordination, resource coordination, and public health in the face of a global pandemic requires a very important step beyond this. It requires the creation of specific definitions and codes in standard terminologies, internationally used code systems for the disease concepts, diagnosis, infectious agents (virus), related lab tests, and other clinical observations related to COVID-19. Two organizations that publish widely used terminologies stepped forward to publish early release versions of new codes and definitions related to COVID-19. Identifier codes and the definitions they are tied to are essential for computer systems in different organizations, different countries, different regions to be able to exchange data and understand the meaning of that data. The very definition of interoperability!
SNOMED International, an organization based in the UK, publishes the code system called SNOMED-CT® (Systemized NOmenclature of MEDicine-Clinical Terms) that defines almost 400,000 clinical concepts. SNOMED has published several codes related to COVID-19, including 840544004, defined as “disease caused by severe acute respiratory syndrome coronavirus 2.” SNOMED codes can be found at (https://snomed.org).
LOINC, an organization based at the Regenstrief Institute, part of the University of Indiana, publishes codes related to laboratory tests and other clinical observations, such as vital signs. Among other added codes, LOINC has started to add codes for the increasing number of laboratory tests related to the SARS-CoV-2 virus, including detecting the presence of the virus in respiratory secretions and detecting antibodies to the virus in an individual who has been exposed. Each different test, developed in a different laboratory, measuring a different substance will have a different LOINC code. There are currently well over 100 tests that have been developed related to the SARS-CoV-2 virus.
The World Health Organization publishes the diagnosis coding system ICD-10-CM used globally. Codes have been added on an emergency basis that include U07.1 defined as COVID-19, virus identified and U07.2 defined as COVID-19, virus not identified. The difference in these, as you may realize, is whether a laboratory test has been performed and is positive for SARS-CoV-2.
Future OnTrak and HealthShare Connections News Flash issues will address related areas of codes for laboratory testing and the importance of standard terminologies in data interoperability, as well as new codes published by organizations maintaining international terminologies.
This story originally appeared in the May 26, 2020- OnTrak News Flash No.4: The Fight Against COVID-19 newsletter and in the May 29, 2020 – HealthShare Connections News Flash No.2: COVID-19 Pandemic newsletter