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Machine-learning-based COVID-19 mortality prediction model and identification of patients at low and high risk of dying.
Banoei, Mohammad M; Dinparastisaleh, Roshan; Zadeh, Ali Vaeli; Mirsaeidi, Mehdi.
  • Banoei MM; Department of Critical Care Medicine, University of Calgary, Alberta, Canada.
  • Dinparastisaleh R; Department of Biological Science, University of Calgary, Alberta, Canada.
  • Zadeh AV; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, 21218, USA.
  • Mirsaeidi M; Division of Pulmonary and Critical Care, Miami VA Medical Center, Miami, FL, USA.
Crit Care ; 25(1): 328, 2021 09 08.
Article in English | MEDLINE | ID: covidwho-1582035
ABSTRACT

BACKGROUND:

The coronavirus disease 2019 (COVID-19) pandemic caused by the SARS-Cov2 virus has become the greatest health and controversial issue for worldwide nations. It is associated with different clinical manifestations and a high mortality rate. Predicting mortality and identifying outcome predictors are crucial for COVID patients who are critically ill. Multivariate and machine learning methods may be used for developing prediction models and reduce the complexity of clinical phenotypes.

METHODS:

Multivariate predictive analysis was applied to 108 out of 250 clinical features, comorbidities, and blood markers captured at the admission time from a hospitalized cohort of patients (N = 250) with COVID-19. Inspired modification of partial least square (SIMPLS)-based model was developed to predict hospital mortality. Prediction accuracy was randomly assigned to training and validation sets. Predictive partition analysis was performed to obtain cutting value for either continuous or categorical variables. Latent class analysis (LCA) was carried to cluster the patients with COVID-19 to identify low- and high-risk patients. Principal component analysis and LCA were used to find a subgroup of survivors that tends to die.

RESULTS:

SIMPLS-based model was able to predict hospital mortality in patients with COVID-19 with moderate predictive power (Q2 = 0.24) and high accuracy (AUC > 0.85) through separating non-survivors from survivors developed using training and validation sets. This model was obtained by the 18 clinical and comorbidities predictors and 3 blood biochemical markers. Coronary artery disease, diabetes, Altered Mental Status, age > 65, and dementia were the topmost differentiating mortality predictors. CRP, prothrombin, and lactate were the most differentiating biochemical markers in the mortality prediction model. Clustering analysis identified high- and low-risk patients among COVID-19 survivors.

CONCLUSIONS:

An accurate COVID-19 mortality prediction model among hospitalized patients based on the clinical features and comorbidities may play a beneficial role in the clinical setting to better management of patients with COVID-19. The current study revealed the application of machine-learning-based approaches to predict hospital mortality in patients with COVID-19 and identification of most important predictors from clinical, comorbidities and blood biochemical variables as well as recognizing high- and low-risk COVID-19 survivors.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / Hospital Mortality / Machine Learning / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Female / Humans / Male Language: English Journal: Crit Care Year: 2021 Document Type: Article Affiliation country: S13054-021-03749-5

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / Hospital Mortality / Machine Learning / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Female / Humans / Male Language: English Journal: Crit Care Year: 2021 Document Type: Article Affiliation country: S13054-021-03749-5