Determination of prognostic markers for COVID-19 disease severity using routine blood tests and machine learning

• Published in: Anais da Academia Brasileira de Ciências Vol. 96; no. 2; p. e20230894
• Main Authors: Lima, Tayná E, Ferraz, Matheus V F, Brito, Carlos A A, Ximenes, Pamella B, Mariz, Carolline A, Braga, Cynthia, Wallau, Gabriel L, Viana, Isabelle F T, Lins, Roberto D
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Academia Brasileira de Ciências 2024
• Subjects: Adult; Aged; Biomarkers - blood; blood tests; Brazil; COVID-19; COVID-19 - blood; COVID-19 - diagnosis; disease prognosis; Female; Ferritins - blood; Hematologic Tests - methods; Humans; Machine Learning; Male; Middle Aged; MULTIDISCIPLINARY SCIENCES; Prognosis; Risk Factors; ROC Curve; SARS-CoV-2; Severity of Illness Index; Brazil; COVID-19; blood tests; machine learning; disease prognosis
• ISSN: 0001-3765; 1678-2690; 1678-2690
• DOI: 10.1590/0001-376520242023089

The need for the identification of risk factors associated to COVID-19 disease severity remains urgent. Patients' care and resource allocation can be potentially different and are defined based on the current classification of disease severity. This classification is based on the analysis of clinical parameters and routine blood tests, which are not standardized across the globe. Some laboratory test alterations have been associated to COVID-19 severity, although these data are conflicting partly due to the different methodologies used across different studies. This study aimed to construct and validate a disease severity prediction model using machine learning (ML). Seventy-two patients admitted to a Brazilian hospital and diagnosed with COVID-19 through RT-PCR and/or ELISA, and with varying degrees of disease severity, were included in the study. Their electronic medical records and the results from daily blood tests were used to develop a ML model to predict disease severity. Using the above data set, a combination of five laboratorial biomarkers was identified as accurate predictors of COVID-19 severe disease with a ROC-AUC of 0.80 ​±​ 0.13. Those biomarkers included prothrombin activity, ferritin, serum iron, ATTP and monocytes. The application of the devised ML model may help rationalize clinical decision and care.