The novel coronavirus disease 2019 (COVID-19) spreads rapidly among people and causes a global pandemic. It is of great clinical significance to identify COVID-19 patients with high risk of death.
A total of 2,169 adult COVID-19 patients were enrolled from Wuhan, China between February 10th and April 15th, 2020. Difference analyses of medical records were performed between severe and non-severe groups as well as between survivors and non-survivors. In addition, we developed a decision tree classifier to identify risk factors for death outcome.
Of the 2,169 COVID-19 patients, the median age was 61 years and male patients accounted for 48%. A total of 646 patients were diagnosed with severe illness, and 75 patients died. The most common system symptoms were respiratory, systemic and digestive symptoms. Obvious differences in demographics, clinical characteristics and laboratory examinations were found between severe and non-severe groups, as well as between survivors and non-survivors. A machine learning model was developed to predict death outcome in severe patients. The decision tree classifier included three biomarkers, neutrophil-to-lymphocyte ratio, C-reactive protein and lactic dehydrogenase. The area under the curve of the receiver operating characteristic of this model was 0.96. This model performed well both in train dataset and test dataset. The accuracy of this model was 0.98 and 0.98, respectively.
The machine learning model was robust and effective in predicting the death outcome in severe COVID-19 patients.