Prognostic Model of COVID-19 Severity and Survival among Hospitalized Patients Using Machine Learning Techniques

Abstract

We conducted a statistical study and developed a machine learning model to triage COVID-19 patients affected during the height of the COVID-19 pandemic in Hong Kong based on their medical records and test results (features) collected during their hospitalization. The correlation between the values of these features is studied against discharge status and disease severity as a preliminary step to identify those features with a more pronounced effect on the patient outcome. Once identified, they constitute the inputs of four machine learning models, Decision Tree, Random Forest, Gradient and RUSBoosting, which predict both the Mortality and Severity associated with the disease. We test the accuracy of the models when the number of input features is varied, demonstrating their stability; i.e., the models are already highly predictive when run over a core set of (6) features. We show that Random Forest and Gradient Boosting classifiers are highly accurate in predicting patients' Mortality (average accuracy ∼99%) as well as categorize patients (average accuracy ∼91%) into four distinct risk classes (Severity of COVID-19 infection). Our methodical and broad approach combines statistical insights with various machine learning models, which paves the way forward in the AI-assisted triage and prognosis of COVID-19 cases, which is potentially generalizable to other seasonal flus.

Keywords: COVID-19; machine learning; triage.

Figure 1

Spearman’s $\rho$—Feature to Feature.

Figure 2

The median (dot) with the interquartile range (solid vertical lines) presented for each test result collected for patients categorized according to their Mortality (red) and Severity (blue) status. Dashed green lines represent the range of normality for the test result.

Figure 3

Mutual information classifier—Severity Outcome (left); Mortality Outcome (right).

Figure 4

Random Forest classifier, Severity (top)—Accuracy: $77.8\%$. Gradient Boosting classifier, Mortality (bottom)—Accuracy: $96.2\%$.

Figure 5

SMOTE—Random Forest classifier, Severity (top)—Accuracy: $90.7\%$. RUS Boosting classifier, Mortality (bottom)—Accuracy: $98.5\%$.