Prediction of COVID-19 deterioration in high-risk patients at diagnosis: an early warning score for advanced COVID-19 developed by machine learning

Jakob, Carolin E. M. and Mahajan, Ujjwal Mukund and Oswald, Marcus and Stecher, Melanie and Schons, Maximilian and Mayerle, Julia and Rieg, Siegbert and Pletz, Mathias and Merle, Uta and Wille, Kai and Borgmann, Stefan and Spinner, Christoph D. and Dolff, Sebastian and Scherer, Clemens and Pilgram, Lisa and Ruethrich, Maria and Hanses, Frank and Hower, Martin and Strauss, Richard and Massberg, Steffen and Er, Ahmet Gorkem and Jung, Norma and Vehreschild, Joerg Janne and Stubbe, Hans and Tometten, Lukas and Koenig, Rainer (2022) Prediction of COVID-19 deterioration in high-risk patients at diagnosis: an early warning score for advanced COVID-19 developed by machine learning. INFECTION, 50 (2). pp. 359-370. ISSN 0300-8126, 1439-0973

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Abstract

Purpose While more advanced COVID-19 necessitates medical interventions and hospitalization, patients with mild COVID-19 do not require this. Identifying patients at risk of progressing to advanced COVID-19 might guide treatment decisions, particularly for better prioritizing patients in need for hospitalization. Methods We developed a machine learning-based predictor for deriving a clinical score identifying patients with asymptomatic/mild COVID-19 at risk of progressing to advanced COVID-19. Clinical data from SARS-CoV-2 positive patients from the multicenter Lean European Open Survey on SARS-CoV-2 Infected Patients (LEOSS) were used for discovery (2020-03-16 to 2020-07-14) and validation (data from 2020-07-15 to 2021-02-16). Results The LEOSS dataset contains 473 baseline patient parameters measured at the first patient contact. After training the predictor model on a training dataset comprising 1233 patients, 20 of the 473 parameters were selected for the predictor model. From the predictor model, we delineated a composite predictive score (SACOV-19, Score for the prediction of an Advanced stage of COVID-19) with eleven variables. In the validation cohort (n = 2264 patients), we observed good prediction performance with an area under the curve (AUC) of 0.73 +/- 0.01. Besides temperature, age, body mass index and smoking habit, variables indicating pulmonary involvement (respiration rate, oxygen saturation, dyspnea), inflammation (CRP, LDH, lymphocyte counts), and acute kidney injury at diagnosis were identified. For better interpretability, the predictor was translated into a web interface. Conclusion We present a machine learning-based predictor model and a clinical score for identifying patients at risk of developing advanced COVID-19.

Item Type: Article
Uncontrolled Keywords: ; COVID-19; Machine learning; Predictive model; Advanced stage; Complicated stage; LEOSS
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Abteilung für Krankenhaushygiene und Infektiologie
Medicine > Notfallambulanz
Depositing User: Dr. Gernot Deinzer
Date Deposited: 21 Sep 2022 09:24
Last Modified: 21 Sep 2022 09:24
URI: https://pred.uni-regensburg.de/id/eprint/47828

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