Predicting lethal courses in critically ill COVID-19 patients using a machine learning model trained on patients with non-COVID-19 viral pneumonia

Abstract In a pandemic with a novel disease, disease-specific prognosis models are available only with a delay. To bridge the critical early phase, models built for similar diseases might be applied. To test the accuracy of such a knowledge transfer, we investigated how precise lethal courses in cri...

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Autores principales: Gregor Lichtner, Felix Balzer, Stefan Haufe, Niklas Giesa, Fridtjof Schiefenhövel, Malte Schmieding, Carlo Jurth, Wolfgang Kopp, Altuna Akalin, Stefan J. Schaller, Steffen Weber-Carstens, Claudia Spies, Falk von Dincklage
Formato: article
Lenguaje:EN
Publicado: Nature Portfolio 2021
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Acceso en línea:https://doaj.org/article/9f0925fd5b874cefbef161561d71441b
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Sumario:Abstract In a pandemic with a novel disease, disease-specific prognosis models are available only with a delay. To bridge the critical early phase, models built for similar diseases might be applied. To test the accuracy of such a knowledge transfer, we investigated how precise lethal courses in critically ill COVID-19 patients can be predicted by a model trained on critically ill non-COVID-19 viral pneumonia patients. We trained gradient boosted decision tree models on 718 (245 deceased) non-COVID-19 viral pneumonia patients to predict individual ICU mortality and applied it to 1054 (369 deceased) COVID-19 patients. Our model showed a significantly better predictive performance (AUROC 0.86 [95% CI 0.86–0.87]) than the clinical scores APACHE2 (0.63 [95% CI 0.61–0.65]), SAPS2 (0.72 [95% CI 0.71–0.74]) and SOFA (0.76 [95% CI 0.75–0.77]), the COVID-19-specific mortality prediction models of Zhou (0.76 [95% CI 0.73–0.78]) and Wang (laboratory: 0.62 [95% CI 0.59–0.65]; clinical: 0.56 [95% CI 0.55–0.58]) and the 4C COVID-19 Mortality score (0.71 [95% CI 0.70–0.72]). We conclude that lethal courses in critically ill COVID-19 patients can be predicted by a machine learning model trained on non-COVID-19 patients. Our results suggest that in a pandemic with a novel disease, prognosis models built for similar diseases can be applied, even when the diseases differ in time courses and in rates of critical and lethal courses.