Predictive models of mortality for hospitalized patients with COVID-19: Retrospective cohort study

Wang，Taiyao1,2,3; Paschalidis，Aris4; Liu，Quanying5; Liu，Yingxia6; Yuan，Ye7; Paschalidis，Ioannis Ch1,2,3

2020-10-01

10.2196/21788

JOURNAL OF MEDICAL INTERNET RESEARCH   影响因子和分区

1438-8871

2291-9694

Background: The novel coronavirus SARS-CoV-2 and its associated disease, COVID-19, have caused worldwide disruption, leading countries to take drastic measures to address the progression of the disease. As SARS-CoV-2 continues to spread, hospitals are struggling to allocate resources to patients who are most at risk. In this context, it has become important to develop models that can accurately predict the severity of infection of hospitalized patients to help guide triage, planning, and resource allocation. Objective: The aim of this study was to develop accurate models to predict the mortality of hospitalized patients with COVID-19 using basic demographics and easily obtainable laboratory data. Methods: We performed a retrospective study of 375 hospitalized patients with COVID-19 in Wuhan, China. The patients were randomly split into derivation and validation cohorts. Regularized logistic regression and support vector machine classifiers were trained on the derivation cohort, and accuracy metrics (F1 scores) were computed on the validation cohort. Two types of models were developed: the first type used laboratory findings from the entire length of the patient’s hospital stay, and the second type used laboratory findings that were obtained no later than 12 hours after admission. The models were further validated on a multicenter external cohort of 542 patients. Results: Of the 375 patients with COVID-19, 174 (46.4%) died of the infection. The study cohort was composed of 224/375 men (59.7%) and 151/375 women (40.3%), with a mean age of 58.83 years (SD 16.46). The models developed using data from throughout the patients’ length of stay demonstrated accuracies as high as 97%, whereas the models with admission laboratory variables possessed accuracies of up to 93%. The latter models predicted patient outcomes an average of 11.5 days in advance. Key variables such as lactate dehydrogenase, high-sensitivity C-reactive protein, and percentage of lymphocytes in the blood were indicated by the models. In line with previous studies, age was also found to be an important variable in predicting mortality. In particular, the mean age of patients who survived COVID-19 infection (50.23 years, SD 15.02) was significantly lower than the mean age of patients who died of the infection (68.75 years, SD 11.83; P<.001). Conclusions: Machine learning models can be successfully employed to accurately predict outcomes of patients with COVID-19. Our models achieved high accuracies and could predict outcomes more than one week in advance; this promising result suggests that these models can be highly useful for resource allocation in hospitals.

China Coronavirus COVID-19 Logistic regression Machine learning Mortality Predictive modeling Support vector machine Wuhan

SCI

英语

其他

National Science Foundation[IIS-1914792][DMS-1664644][CNS-1645681] ; Office of Naval Research under MURI grant[N00014-19-1-2571] ; National Institutes of Health[1R01GM135930]

Health Care Sciences & Services ; Medical Informatics

Health Care Sciences & Services ; Medical Informatics

WOS:000585067200008

JMIR PUBLICATIONS, INC

CLINICAL MEDICINE

2-s2.0-85097460430

Scopus

1.Department of Electrical and Computer Engineering,Boston University,Boston,United States
2.Department of Biomedical Engineering,Boston University,Boston,United States
3.Center for Information and Systems Engineering,Boston University,Boston,United States
4.Brown University,Providence,United States
5.Department of Biomedical Engineering,University of Science and Technology,Shenzen,China
6.Third People’s Hospital of Shenzhen,Second Hospital Affiliated to Southern University of Science and Technology,Shenzen,China
7.School of Artificial Intelligence and Automation,Huazhong University of Science and Technology,Wuhan,China

Wang，Taiyao,Paschalidis，Aris,Liu，Quanying,et al. Predictive models of mortality for hospitalized patients with COVID-19: Retrospective cohort study[J]. JOURNAL OF MEDICAL INTERNET RESEARCH,2020,8(10).

Wang，Taiyao,Paschalidis，Aris,Liu，Quanying,Liu，Yingxia,Yuan，Ye,&Paschalidis，Ioannis Ch.(2020).Predictive models of mortality for hospitalized patients with COVID-19: Retrospective cohort study.JOURNAL OF MEDICAL INTERNET RESEARCH,8(10).

Wang，Taiyao,et al."Predictive models of mortality for hospitalized patients with COVID-19: Retrospective cohort study".JOURNAL OF MEDICAL INTERNET RESEARCH 8.10(2020).