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Risk Factors Associated with In-Hospital Mortality in Iranian Patients with COVID-19: Application of Machine Learning

Shafiekhani Sadjad, Rafiei Sima, Abdollahzade Sina, Souri Saber, Moomeni Zeinab

Polish Journal of Medical Physics and Engineering

2022

Vol. 28, Iss. 1

19--29

Introduction: Predicting the mortality risk of COVID-19 patients based on patient's physiological conditions and demographic characteristics can help optimize resource consumption along with the provision of effective medical services for patients. In the current study, we aimed to develop several machine learning models to forecast the mortality risk in COVID-19 patients, evaluate their performance, and select the model with the highest predictive power. Material and methods: We conducted a retrospective analysis of the records belonging to COVID-19 patients admitted to one of the main hospitals of Qazvin located in the northwest of Iran over 12 months period. We selected 29 variables for developing machine learning models incorporating demographic factors, physical symptoms, comorbidities, and laboratory test results. The outcome variable was mortality as a binary variable. Logistic regression analysis was conducted to identify risk factors of in-hospital death. Results: In prediction of mortality, Ensemble demonstrated the maximum values of accuracy (0.8071, 95%CI: 0.7787, 0.8356), F1-score (0.8121 95%CI: 0.7900, 0.8341), and AUROC (0.8079, 95%CI: 0.7800, 0.8358). Including fourteen top-scored features identified by maximum relevance minimum redundancy algorithm into the subset of predictors of ensemble classifier such as BUN level, shortness of breath, seizure, disease history, fever, gender, body pain, WBC, diarrhea, sore throat, blood oxygen level, muscular pain, lack of taste and history of drug (medication) use are sufficient for this classifier to reach to its best predictive power for prediction of mortality risk of COVID-19 patients. Conclusions: Study findings revealed that old age, lower oxygen saturation level, underlying medical conditions, shortness of breath, seizure, fever, sore throat, and body pain, besides serum BUN, WBC, and CRP levels, were significantly associated with increased mortality risk of COVID-19 patients. Machine learning algorithms can help healthcare systems by predicting and reduction of the mortality risk of COVID-19 patients.

Trend and prediction of COVID-19 outbreak in Iran: SEIR and ANFIS model

Shafiekhani Sajad, Khalilabad Touraj Harati, Rafiei Sima, Sadeghi Vahid, Jafari Amir Homayoun, Gheibi Nematollah

Polish Journal of Medical Physics and Engineering

2021

Vol. 27, Iss. 3

241--249

Background: Mathematical and predictive modeling approaches can be used in COVID-19 crisis to forecast the trend of new cases for healthcare management purposes. Given the COVID-19 disease pandemic, the prediction of the epidemic trend of this disease is so important. Methods: We constructed an SEIR (Susceptible-Exposed-Infected-Recovered) model on the COVID-19 outbreak in Iran. We estimated model parameters by the data on notified cases in Iran in the time window 1/22/2020 – 20/7/2021. Global sensitivity analysis is performed to determine the correlation between epidemiological variables and SEIR model parameters and to assess SEIR model robustness against perturbation to parameters. We Combined Adaptive Neuro- Fuzzy Inference System (ANFIS) as a rigorous time series prediction approach with the SEIR model to predict the trend of COVID-19 new cases under two different scenarios including social distance and non-social distance. Results: The SEIR and ANFIS model predicted new cases of COVID-19 for the period February 7, 2021, till August 7, 2021. Model predictions in the non-social distancing scenario indicate that the corona epidemic in Iran may recur as an immortal oscillation and Iran may undergo a recurrence of the third peak. Conclusion: Combining parametrized SEIR model and ANFIS is effective in predicting the trend of COVID-19 new cases in Iran.