Jorge Mateo

Different demographic, clinical and laboratory variables have been related to the severity and mortality following SARS-CoV-2 infection. Most studies applied traditional statistical methods and in some cases combined with a machine learning (ML) method. This is the first study to date to comparatively analyze five ML methods to select the one that most closely predicts mortality in patients admitted with COVID-19. The aim of this single-center observational study is to classify, based on different types of variables, adult patients with COVID-19 at increased risk of mortality. SARS-CoV-2 infection was defined by a positive reverse transcriptase PCR. A total of 203 patients were admitted between March 15 and June 15, 2020 to a tertiary hospital. Data were extracted from the electronic medical record. Four supervised ML algorithms (k-nearest neighbors (KNN), decision tree (DT), Gaussian naïve Bayes (GNB) and support vector machine (SVM)) were compared with the eXtreme Gradient Boosting (XGB) method proposed to have excellent scalability and high running speed, among other qualities. The results indicate that the XGB method has the best prediction accuracy (92%), high precision (>0.92) and high recall (>0.92). The KNN, SVM and DT approaches present moderate prediction accuracy (>80%), moderate recall (>0.80) and moderate precision (>0.80). The GNB algorithm shows relatively low classification performance. The variables with the greatest weight in predicting mortality were C reactive protein, procalcitonin, glutamyl oxaloacetic transaminase, glutamyl pyruvic transaminase, neutrophils, D-dimer, creatinine, lactic acid, ferritin, days of non-invasive ventilation, septic shock and age. Based on these results, XGB is a solid candidate for correct classification of patients with COVID-19.