Prediction of in‐hospital mortality with machine learning for COVID‐19 patients treated with steroid and remdesivir

• Published in: Journal of Medical Virology 2022-03, Vol.94 (3), p.958-964
• Main Authors: Kuno, Toshiki, Sahashi, Yuki, Kawahito, Shinpei, Takahashi, Mai, Iwagami, Masao, Egorova, Natalia N.
• Format: Article
• Language: English
• Subjects: Adenosine Monophosphate - analogs & derivatives; Alanine - analogs & derivatives; Antiviral drugs; Blood; Coronaviruses; COVID-19; COVID-19 - drug therapy; Datasets; Hospital Mortality; Humans; Hypertension; Intensive care; Intubation; Learning algorithms; Machine Learning; Mortality; New York; Nitrogen; Oxygen content; Oxygen saturation; Patients; Prediction models; remdesivir; steroid; Steroid hormones; Steroids; Steroids - therapeutic use; Training; Urea; Viral diseases; Virology
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.27393

We aimed to create the prediction model of in‐hospital mortality using machine learning methods for patients with coronavirus disease 2019 (COVID‐19) treated with steroid and remdesivir. We reviewed 1571 hospitalized patients with laboratory confirmed COVID‐19 from the Mount Sinai Health System treated with both steroids and remdesivir. The important variables associated with in‐hospital mortality were identified using LASSO (least absolute shrinkage and selection operator) and SHAP (SHapley Additive exPlanations) through the light gradient boosting model (GBM). The data before February 17th, 2021 (N = 769) was randomly split into training and testing datasets; 80% versus 20%, respectively. Light GBM models were created with train data and area under the curves (AUCs) were calculated. Additionally, we calculated AUC with the data between February 17th, 2021 and March 30th, 2021 (N = 802). Of the 1571 patients admitted due to COVID‐19, 331 (21.1%) died during hospitalization. Through LASSO and SHAP, we selected six important variables; age, hypertension, oxygen saturation, blood urea nitrogen, intensive care unit admission, and endotracheal intubation. AUCs using training and testing datasets derived from the data before February 17th, 2021 were 0.871/0.911. Additionally, the light GBM model has high predictability for the latest data (AUC: 0.881) (https://risk-model.herokuapp.com/covid). A high‐value prediction model was created to estimate in‐hospital mortality for COVID‐19 patients treated with steroid and remdesivir. HIGHLIGHTS • Through LASSO and SHAP techniques, we selected six important variables associated with death of patients infected with COVID‐19: age, hypertension, oxygen saturation, blood urea nitrogen, intensive care unit admission, and endotracheal intubation. • Area under the curves (AUCs) using training and testing datasets derived from the data before February 17th, 2021 were 0.871/0.911. • Additionally, the light gradient boosting model model has high predictability for the latest data (AUC: 0.881).