https://pubmed.ncbi.nlm.nih.gov/41259033/

Background

Whether SARS-CoV-2 infection leaves a durable cardiovascular signature in children was an open question, and answering it required both a large pediatric cohort and a way to handle the fact that participating institutions serve very different populations. Ignoring that heterogeneity risks reading institutional composition as a biological effect. The analysis drew on a United States pediatric centralized network covering 719,383 patients.

Method

COLA-GLM-H is the heterogeneity-aware member of the COLA family. It reconstructs the global likelihood for generalized linear models from institution-level summary statistics alone, while modeling site-specific effects directly rather than assuming a common intercept. Estimation is lossless and completes in one round. The same algorithm was exercised on an internationally decentralized network of 120,429 hospitalized patients across seven databases in three countries.

Main finding

Elevated long-term cardiovascular risk following infection was detectable in the pediatric cohort after case-mix adjustment, with the magnitude varying across contributing institutions. Because the site-specific effects were modeled rather than averaged away, the analysis could separate genuine post-infection risk from differences in which children each institution serves.