Abstract
Background: Early detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients who could develop a severe form of COVID-19 must be considered of great importance to carry out adequate care and optimise the use of limited resources.
Aims: To use several machine learning classification models to analyse a series of non-critically ill COVID-19 patients admitted to a general medicine ward to verify if any clinical variables recorded could predict the clinical outcome.
Methods: We retrospectively analysed non-critically ill patients with COVID-19 admitted to the general ward of the hospital in Pordenone from 1 March 2020 to 30 April 2020. Patients’ characteristics were compared based on clinical outcomes. Through several machine learning classification models, some predictors for clinical outcome were detected.
Results: In the considered period, we analysed 176 consecutive patients admitted: 119 (67.6%) were discharged, 35 (19.9%) dead and 22 (12.5%) were transferred to intensive care unit. The most accurate models were a random forest model (M2) and a conditional inference tree model (M5) (accuracy = 0.79; 95% confidence interval 0.64-0.90, for both). For M2, glomerular filtration rate and creatinine were the most accurate predictors for the outcome, followed by age and fraction-inspired oxygen. For M5, serum sodium, body temperature and arterial pressure of oxygen and inspiratory fraction of oxygen ratio were the most reliable predictors.
Conclusions: In non-critically ill COVID-19 patients admitted to a medical ward, glomerular filtration rate, creatinine and serum sodium were promising predictors for the clinical outcome. Some factors not determined by COVID-19, such as age or dementia, influence clinical outcomes.
Keywords: COVID-19; machine learning; non-critically ill; prediction.
【저자키워드】 COVID-19, machine learning, prediction, non-critically ill, 【초록키워드】 coronavirus, intensive care, sodium, machine learning, hospital, intensive care unit, oxygen, predictors, outcome, severe acute respiratory syndrome Coronavirus, clinical outcomes, Clinical outcome, Dementia, Critically ill, Characteristics, Accuracy, Early detection, Patient, Random forest, age, predictor, Care, predict, body temperature, glomerular filtration rate, creatinine, COVID-19 patient, followed by, arterial pressure, determined by, filtration rate, acute respiratory syndrome, Factor, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, 95% confidence interval, fraction, serum sodium, random, dead, non-critically ill patients, resources, Pordenone, develop, analysed, discharged, recorded, clinical variable, consecutive patient, non-critically ill patient, transferred, with COVID-19, 【제목키워드】 classification, outcome, predictor, Analysis, COVID-19 patient,