scholarly journals Clinical Characteristics and Prognostic Factors for ICU Admission of Patients with COVID-19 Using Machine Learning and Natural Language Processing

2020 ◽  
Author(s):  
Jose L. Izquierdo ◽  
Julio Ancochea ◽  
Joan B. Soriano
2020 ◽  
Author(s):  
Jose Luis Izquierdo ◽  
Julio Ancochea ◽  
Joan B Soriano ◽  

BACKGROUND Many factors involved in the onset and clinical course of the ongoing COVID-19 pandemic are still unknown. Although big data analytics and artificial intelligence are widely used in the realms of health and medicine, researchers are only beginning to use these tools to explore the clinical characteristics and predictive factors of patients with COVID-19. OBJECTIVE Our primary objectives are to describe the clinical characteristics and determine the factors that predict intensive care unit (ICU) admission of patients with COVID-19. Determining these factors using a well-defined population can increase our understanding of the real-world epidemiology of the disease. METHODS We used a combination of classic epidemiological methods, natural language processing (NLP), and machine learning (for predictive modeling) to analyze the electronic health records (EHRs) of patients with COVID-19. We explored the unstructured free text in the EHRs within the Servicio de Salud de Castilla-La Mancha (SESCAM) Health Care Network (Castilla-La Mancha, Spain) from the entire population with available EHRs (1,364,924 patients) from January 1 to March 29, 2020. We extracted related clinical information regarding diagnosis, progression, and outcome for all COVID-19 cases. RESULTS A total of 10,504 patients with a clinical or polymerase chain reaction–confirmed diagnosis of COVID-19 were identified; 5519 (52.5%) were male, with a mean age of 58.2 years (SD 19.7). Upon admission, the most common symptoms were cough, fever, and dyspnea; however, all three symptoms occurred in fewer than half of the cases. Overall, 6.1% (83/1353) of hospitalized patients required ICU admission. Using a machine-learning, data-driven algorithm, we identified that a combination of age, fever, and tachypnea was the most parsimonious predictor of ICU admission; patients younger than 56 years, without tachypnea, and temperature <39 degrees Celsius (or >39 ºC without respiratory crackles) were not admitted to the ICU. In contrast, patients with COVID-19 aged 40 to 79 years were likely to be admitted to the ICU if they had tachypnea and delayed their visit to the emergency department after being seen in primary care. CONCLUSIONS Our results show that a combination of easily obtainable clinical variables (age, fever, and tachypnea with or without respiratory crackles) predicts whether patients with COVID-19 will require ICU admission.


10.2196/21801 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e21801 ◽  
Author(s):  
Jose Luis Izquierdo ◽  
Julio Ancochea ◽  
Joan B Soriano ◽  

Background Many factors involved in the onset and clinical course of the ongoing COVID-19 pandemic are still unknown. Although big data analytics and artificial intelligence are widely used in the realms of health and medicine, researchers are only beginning to use these tools to explore the clinical characteristics and predictive factors of patients with COVID-19. Objective Our primary objectives are to describe the clinical characteristics and determine the factors that predict intensive care unit (ICU) admission of patients with COVID-19. Determining these factors using a well-defined population can increase our understanding of the real-world epidemiology of the disease. Methods We used a combination of classic epidemiological methods, natural language processing (NLP), and machine learning (for predictive modeling) to analyze the electronic health records (EHRs) of patients with COVID-19. We explored the unstructured free text in the EHRs within the Servicio de Salud de Castilla-La Mancha (SESCAM) Health Care Network (Castilla-La Mancha, Spain) from the entire population with available EHRs (1,364,924 patients) from January 1 to March 29, 2020. We extracted related clinical information regarding diagnosis, progression, and outcome for all COVID-19 cases. Results A total of 10,504 patients with a clinical or polymerase chain reaction–confirmed diagnosis of COVID-19 were identified; 5519 (52.5%) were male, with a mean age of 58.2 years (SD 19.7). Upon admission, the most common symptoms were cough, fever, and dyspnea; however, all three symptoms occurred in fewer than half of the cases. Overall, 6.1% (83/1353) of hospitalized patients required ICU admission. Using a machine-learning, data-driven algorithm, we identified that a combination of age, fever, and tachypnea was the most parsimonious predictor of ICU admission; patients younger than 56 years, without tachypnea, and temperature <39 degrees Celsius (or >39 ºC without respiratory crackles) were not admitted to the ICU. In contrast, patients with COVID-19 aged 40 to 79 years were likely to be admitted to the ICU if they had tachypnea and delayed their visit to the emergency department after being seen in primary care. Conclusions Our results show that a combination of easily obtainable clinical variables (age, fever, and tachypnea with or without respiratory crackles) predicts whether patients with COVID-19 will require ICU admission.


Author(s):  
Jose L. Izquierdo ◽  
Julio Ancochea ◽  
Joan B. Soriano ◽  

ABSTRACTThere remain many unknowns regarding the onset and clinical course of the ongoing COVID-19 pandemic. We used a combination of classic epidemiological methods, natural language processing (NLP), and machine learning (for predictive modeling), to analyse the electronic health records (EHRs) of patients with COVID-19.We explored the unstructured free text in the EHRs within the SESCAM Healthcare Network (Castilla La-Mancha, Spain) from the entire population with available EHRs (1,364,924 patients) from January 1st to March 29th, 2020. We extracted related clinical information upon diagnosis, progression and outcome for all COVID-19 cases, focusing in those requiring ICU admission.A total of 10,504 patients with a clinical or PCR-confirmed diagnosis of COVID-19 were identified, 52.5% males, with age of 58.2±19.7 years. Upon admission, the most common symptoms were cough, fever, and dyspnoea, but all in less than half of cases. Overall, 6% of hospitalized patients required ICU admission. Using a machine-learning, data-driven algorithm we identified that a combination of age, fever, and tachypnoea was the most parsimonious predictor of ICU admission: those younger than 56 years, without tachypnoea, and temperature <39°C, (or >39°C without respiratory crackles), were free of ICU admission. On the contrary, COVID-19 patients aged 40 to 79 years were likely to be admitted to the ICU if they had tachypnoea and delayed their visit to the ER after being seen in primary care.Our results show that a combination of easily obtainable clinical variables (age, fever, and tachypnoea with/without respiratory crackles) predicts which COVID-19 patients require ICU admission.


Author(s):  
Rohan Pandey ◽  
Vaibhav Gautam ◽  
Ridam Pal ◽  
Harsh Bandhey ◽  
Lovedeep Singh Dhingra ◽  
...  

BACKGROUND The COVID-19 pandemic has uncovered the potential of digital misinformation in shaping the health of nations. The deluge of unverified information that spreads faster than the epidemic itself is an unprecedented phenomenon that has put millions of lives in danger. Mitigating this ‘Infodemic’ requires strong health messaging systems that are engaging, vernacular, scalable, effective and continuously learn the new patterns of misinformation. OBJECTIVE We created WashKaro, a multi-pronged intervention for mitigating misinformation through conversational AI, machine translation and natural language processing. WashKaro provides the right information matched against WHO guidelines through AI, and delivers it in the right format in local languages. METHODS We theorize (i) an NLP based AI engine that could continuously incorporate user feedback to improve relevance of information, (ii) bite sized audio in the local language to improve penetrance in a country with skewed gender literacy ratios, and (iii) conversational but interactive AI engagement with users towards an increased health awareness in the community. RESULTS A total of 5026 people who downloaded the app during the study window, among those 1545 were active users. Our study shows that 3.4 times more females engaged with the App in Hindi as compared to males, the relevance of AI-filtered news content doubled within 45 days of continuous machine learning, and the prudence of integrated AI chatbot “Satya” increased thus proving the usefulness of an mHealth platform to mitigate health misinformation. CONCLUSIONS We conclude that a multi-pronged machine learning application delivering vernacular bite-sized audios and conversational AI is an effective approach to mitigate health misinformation. CLINICALTRIAL Not Applicable


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