At-admission prediction of mortality and pulmonary embolism in an international cohort of hospitalised patients with COVID-19 using statistical and machine learning methods

Mesinovic, M.; Wong, X.C.; Rajahram, G.S.; Citarella, B.W.; Peariasamy, K.M.; Van Someren Greve, F.; Olliaro, P.; Merson, L.; Clifton, L.; Kartsonaki, C.; Null, N.; Abdukahil, S.A.; Abdulkadir, N.N.; Abe, R.; Abel, L.; Abrous, A.; Absil, L.; Acker, A.; Adachi, S.; Adam, E.; Adriano, E.; Adrião, D.; Ageel, S.A.; Ahmed, S.; Aiello, M.; Ainscough, K.; Airlangga, E.; Aisa, T.; Hssain, A.A.; Tamlihat, Y.A.; Akimoto, T.; Akmal, E.; Qasim, E.A.; Alalqam, R.; Alberti, A.; Al-dabbous, T.; Alegesan, S.; Alegre, C.; Alessi, M.; Alex, B.; Alexandre, K.; Al-Fares, A.; Alfoudri, H.; Ali, A.; Ali, I.; Alidjnou, K.E.; Aliudin, J.; Alkhafajee, Q.; Allavena, C.; Allou, N.; Alves, J.; Alves, J.M.; Alves, R.; Cabrita, J.A.; Amaral, M.; Amira, N.; Ammerlaan, H.; Ampaw, P.; Andini, R.; Andréjak, C.; Angheben, A.; Angoulvant, F.; Ansart, S.; Anthonidass, S.; Antonelli, M.; De Brito, C.A.A.; Anwar, K.R.; Apriyana, A.; Arabi, Y.; Aragao, I.; Arancibia, F.; Araujo, C.; Arcadipane, A.; Archambault, P.; Arenz, L.; Arlet, J.; Arnold-Day, C.; Arora, L.; Arora, R.; Artaud-Macari, E.; Aryal, D.; Asaki, M.; Asensio, A.; Ashley, E.A.; Ashraf, M.; Assie, J.B.; Asyraf, A.; Atique, A.; Attanyake, A.U.L.; Auchabie, J.; Aumaitre, H.; Auvet, A.; Azemar, L.; Azoulay, C.; Bach, B.; Bachelet, D.; Badr, C.; Baig, N.; Baillie, J.K.; Baird, J.K.; Bak, E.; Bakakos, A.; Bakar, N.A.; Bal, A.; Balakrishnan, M.; Balan, V.; Bani-Sadr, F.; Barbalho, R.; Barbosa, N.Y.; Barclay, W.S.; Barnett, S.U.; Barnikel, M.; Barrasa, H.; Barrelet, A.; Barrigoto, C.; Bartoli, M.; Baruch, J.; Basmaci, R.; Basri, M.F.H.; Battaglini, D.; Bauer, J.; Rincon, D.F.B.; Dow, D.B.; Beane, A.; Bedossa, A.; Bee, K.H.; Begum, H.; Behilill, S.; Beishuizen, A.; Beljantsev, A.; Bellemare, D.; Beltrame, A.; Beltrão, B.A.; Beluze, M.; Benech, N.; Benjiman, L.E.; Benkerrou, D.; Bennett, S.; Bento, L.; Berdal, J.; Bergeaud, D.; Bergin, H.; Bertoli, G.; Bertolino, L.; Bessis, S.; Betz, A.; Bevilcaqua, S.; Bezulier, K.; Bhatt, A.; Bhavsar, K.; Bianco, C.; Bidin, F.N.; Singh, M.B.; Humaid, F.B.; Kamarudin, M.N.B.; Bisoffi, Z.; Bissuel, F.; Biston, P.; Bitker, L.; Bitton, J.; Blanco-Schweizer, P.; Blier, C.; Bloos, F.; Blot, M.; Blumberg, L.; Boccia, F.; Bodenes, L.; Bogaert, D.; Boivin, A.; Bolaños, I.; Bolze, P.; Bompart, F.; Bonelli, P.; Bonfasius, A.; Borges, D.; Borie, R.; Bosse, H.M.; Botelho-Nevers, E.; Bouadma, L.; Bouchaud, O.; Bouchez, S.; Bouhmani, D.; Bouhour, D.; Bouiller, K.; Bouillet, L.; Bouisse, C.; Bounphiengsy, T.; Bountthasavong, L.; Boureau, A.; Bourke, J.; Bouscambert, M.; Bousquet, A.; Bouziotis, J.; Boxma, B.; Boyer-Besseyre, M.; Boylan, M.; Bozza, F.A.; Braconnier, A.; Braga, C.; Brandenburger, T.; Monteiro, F.B.; Brazzi, L.; Breen, D.; Breen, P.; Brewster, D.; Brickell, K.; Browne, A.; Browne, S.; Brozzi, N.; Brusse-Keizer, M.; Buchtele, N.; Bugaeva, P.; Buisson, M.; Buonsenso, D.; Burhan, E.; Burrell, A.; Bustos, I.G.; Butnaru, D.; Cabie, A.; Cabral, S.; Caceres, E.; Cadoz, C.; Garcês, R.C.; Callahan, M.; Calligy, K.; 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doi:10.1038/s41598-024-63212-7

By September 2022, more than 600 million cases of SARS-CoV-2 infection have been reported globally, resulting in over 6.5 million deaths. COVID-19 mortality risk estimators are often, however, developed with small unrepresentative samples and with methodological limitations. It is highly important to develop predictive tools for pulmonary embolism (PE) in COVID-19 patients as one of the most severe preventable complications of COVID-19. Early recognition can help provide life-saving targeted anti-coagulation therapy right at admission. Using a dataset of more than 800,000 COVID-19 patients from an international cohort, we propose a cost-sensitive gradient-boosted machine learning model that predicts occurrence of PE and death at admission. Logistic regression, Cox proportional hazards models, and Shapley values were used to identify key predictors for PE and death. Our prediction model had a test AUROC of 75.9% and 74.2%, and sensitivities of 67.5% and 72.7% for PE and all-cause mortality respectively on a highly diverse and held-out test set. The PE prediction model was also evaluated on patients in UK and Spain separately with test results of 74.5% AUROC, 63.5% sensitivity and 78.9% AUROC, 95.7% sensitivity. Age, sex, region of admission, comorbidities (chronic cardiac and pulmonary disease, dementia, diabetes, hypertension, cancer, obesity, smoking), and symptoms (any, confusion, chest pain, fatigue, headache, fever, muscle or joint pain, shortness of breath) were the most important clinical predictors at admission. Age, overall presence of symptoms, shortness of breath, and hypertension were found to be key predictors for PE using our extreme gradient boosted model. This analysis based on the, until now, largest global dataset for this set of problems can inform hospital prioritisation policy and guide long term clinical research and decision-making for COVID-19 patients globally. Our machine learning model developed from an international cohort can serve to better regulate hospital risk prioritisation of at-risk patients.

At-admission prediction of mortality and pulmonary embolism in an international cohort of hospitalised patients with COVID-19 using statistical and machine learning methods / M. Mesinovic, X.C. Wong, G.S. Rajahram, B.W. Citarella, K.M. Peariasamy, F. Van Someren Greve, P. Olliaro, L. Merson, L. Clifton, C. Kartsonaki, N. Null, S.A. Abdukahil, N.N. Abdulkadir, R. Abe, L. Abel, A. Abrous, L. Absil, A. Acker, S. Adachi, E. Adam, E. Adriano, D. Adrião, S.A. Ageel, S. Ahmed, M. Aiello, K. Ainscough, E. Airlangga, T. Aisa, A.A. Hssain, Y.A. Tamlihat, T. Akimoto, E. Akmal, E.A. Qasim, R. Alalqam, A. Alberti, T. Al-dabbous, S. Alegesan, C. Alegre, M. Alessi, B. Alex, K. Alexandre, A. Al-Fares, H. Alfoudri, A. Ali, I. Ali, K.E. Alidjnou, J. Aliudin, Q. Alkhafajee, C. Allavena, N. Allou, J. Alves, J.M. Alves, R. Alves, J.A. Cabrita, M. Amaral, N. Amira, H. Ammerlaan, P. Ampaw, R. Andini, C. Andréjak, A. Angheben, F. Angoulvant, S. Ansart, S. Anthonidass, M. Antonelli, C.A.A. De Brito, K.R. Anwar, A. Apriyana, Y. Arabi, I. Aragao, F. Arancibia, C. Araujo, A. Arcadipane, P. Archambault, L. Arenz, J. Arlet, C. Arnold-Day, L. Arora, R. Arora, E. Artaud-Macari, D. Aryal, M. Asaki, A. Asensio, E.A. Ashley, M. Ashraf, J.B. Assie, A. Asyraf, A. Atique, A.U.L. Attanyake, J. Auchabie, H. Aumaitre, A. Auvet, L. Azemar, C. Azoulay, B. Bach, D. Bachelet, C. Badr, N. Baig, J.K. Baillie, J.K. Baird, E. Bak, A. Bakakos, N.A. Bakar, A. Bal, M. Balakrishnan, V. Balan, F. Bani-Sadr, R. Barbalho, N.Y. Barbosa, W.S. Barclay, S.U. Barnett, M. Barnikel, H. Barrasa, A. Barrelet, C. Barrigoto, M. Bartoli, J. Baruch, R. Basmaci, M.F.H. Basri, D. Battaglini, J. Bauer, D.F.B. Rincon, D.B. Dow, A. Beane, A. Bedossa, K.H. Bee, H. Begum, S. Behilill, A. Beishuizen, A. Beljantsev, D. Bellemare, A. Beltrame, B.A. Beltrão, M. Beluze, N. Benech, L.E. Benjiman, D. Benkerrou, S. Bennett, L. Bento, J. Berdal, D. Bergeaud, H. Bergin, G. Bertoli, L. Bertolino, S. Bessis, A. Betz, S. Bevilcaqua, K. 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At-admission prediction of mortality and pulmonary embolism in an international cohort of hospitalised patients with COVID-19 using statistical and machine learning methods

Mesinovic, Munib;Wong, Xin Ci;Rajahram, Giri Shan;Citarella, Barbara Wanjiru;Peariasamy, Kalaiarasu M.;van Someren Greve, Frank;Olliaro, Piero;Merson, Laura;Clifton, Lei;Kartsonaki, Christiana;null, null;Abdukahil, Sheryl Ann;Abdulkadir, Nurul Najmee;Abe, Ryuzo;Abel, Laurent;Abrous, Amal;Absil, Lara;Acker, Andrew;Adachi, Shingo;Adam, Elisabeth;Adriano, Enrico;Adrião, Diana;Ageel, Saleh Al;Ahmed, Shakeel;Aiello, Marina;Ainscough, Kate;Airlangga, Eka;Aisa, Tharwat;Hssain, Ali Ait;Tamlihat, Younes Ait;Akimoto, Takako;Akmal, Ernita;Qasim, Eman Al;Alalqam, Razi;Alberti, Angela;Al-dabbous, Tala;Alegesan, Senthilkumar;Alegre, Cynthia;Alessi, Marta;Alex, Beatrice;Alexandre, Kévin;Al-Fares, Abdulrahman;Alfoudri, Huda;Ali, Adam;Ali, Imran;Alidjnou, Kazali Enagnon;Aliudin, Jeffrey;Alkhafajee, Qabas;Allavena, Clotilde;Allou, Nathalie;Alves, João;Alves, João Melo;Alves, Rita;Cabrita, Joana Alves;Amaral, Maria;Amira, Nur;Ammerlaan, Heidi;Ampaw, Phoebe;Andini, Roberto;Andréjak, Claire;Angheben, Andrea;Angoulvant, François;Ansart, Séverine;Anthonidass, Sivanesen;Antonelli, Massimo;de Brito, Carlos Alexandre Antunes;Anwar, Kazi Rubayet;Apriyana, Ardiyan;Arabi, Yaseen;Aragao, Irene;Arancibia, Francisco;Araujo, Carolline;Arcadipane, Antonio;Archambault, Patrick;Arenz, Lukas;Arlet, Jean-Benoît;Arnold-Day, Christel;Arora, Lovkesh;Arora, Rakesh;Artaud-Macari, Elise;Aryal, Diptesh;Asaki, Motohiro;Asensio, Angel;Ashley, Elizabeth A.;Ashraf, Muhammad;Assie, Jean Baptiste;Asyraf, Amirul;Atique, Anika;Attanyake, AM Udara Lakshan;Auchabie, Johann;Aumaitre, Hugues;Auvet, Adrien;Azemar, Laurène;Azoulay, Cecile;Bach, Benjamin;Bachelet, Delphine;Badr, Claudine;Baig, Nadia;Baillie, J. Kenneth;Baird, J Kevin;Bak, Erica;Bakakos, Agamemnon;Bakar, Nazreen Abu;Bal, Andriy;Balakrishnan, Mohanaprasanth;Balan, Valeria;Bani-Sadr, Firouzé;Barbalho, Renata;Barbosa, Nicholas Yuri;Barclay, Wendy S.;Barnett, Saef Umar;Barnikel, Michaela;Barrasa, Helena;Barrelet, Audrey;Barrigoto, Cleide;Bartoli, Marie;Baruch, Joaquín;Basmaci, Romain;Basri, Muhammad Fadhli Hassin;Battaglini, Denise;Bauer, Jules;Rincon, Diego Fernando Bautista;Dow, Denisse Bazan;Beane, Abigail;Bedossa, Alexandra;Bee, Ker Hong;Begum, Husna;Behilill, Sylvie;Beishuizen, Albertus;Beljantsev, Aleksandr;Bellemare, David;Beltrame, Anna;Beltrão, Beatriz Amorim;Beluze, Marine;Benech, Nicolas;Benjiman, Lionel Eric;Benkerrou, Dehbia;Bennett, Suzanne;Bento, Luís;Berdal, Jan-Erik;Bergeaud, Delphine;Bergin, Hazel;Bertoli, Giulia;Bertolino, Lorenzo;Bessis, Simon;Betz, Adam;Bevilcaqua, Sybille;Bezulier, Karine;Bhatt, Amar;Bhavsar, Krishna;Bianco, Claudia;Bidin, Farah Nadiah;Singh, Moirangthem Bikram;Humaid, Felwa Bin;Kamarudin, Mohd Nazlin Bin;Bisoffi, Zeno;Bissuel, François;Biston, Patrick;Bitker, Laurent;Bitton, Jonathan;Blanco-Schweizer, Pablo;Blier, Catherine;Bloos, Frank;Blot, Mathieu;Blumberg, Lucille;Boccia, Filomena;Bodenes, Laetitia;Bogaert, Debby;Boivin, Anne-Hélène;Bolaños, Isabela;Bolze, Pierre-Adrien;Bompart, François;Bonelli, Patrizia;Bonfasius, Aurelius;Borges, Diogo;Borie, Raphaël;Bosse, Hans Martin;Botelho-Nevers, Elisabeth;Bouadma, Lila;Bouchaud, Olivier;Bouchez, Sabelline;Bouhmani, Dounia;Bouhour, Damien;Bouiller, Kévin;Bouillet, Laurence;Bouisse, Camile;Bounphiengsy, Thipsavanh;Bountthasavong, Latsaniphone;Boureau, Anne-Sophie;Bourke, John;Bouscambert, Maude;Bousquet, Aurore;Bouziotis, Jason;Boxma, Bianca;Boyer-Besseyre, Marielle;Boylan, Maria;Bozza, Fernando Augusto;Braconnier, Axelle;Braga, Cynthia;Brandenburger, Timo;Monteiro, Filipa Brás;Brazzi, Luca;Breen, Dorothy;Breen, Patrick;Brewster, David;Brickell, Kathy;Browne, Alex;Browne, Shaunagh;Brozzi, Nicolas;Brusse-Keizer, Marjolein;Buchtele, Nina;Bugaeva, Polina;Buisson, Marielle;Buonsenso, Danilo;Burhan, Erlina;Burrell, Aidan;Bustos, Ingrid G.;Butnaru, Denis;Cabie, André;Cabral, Susana;Caceres, Eder;Cadoz, Cyril;Garcês, Rui Caetano;Callahan, Mia;Calligy, Kate;Calvache, Jose Andres;Caminiti, Caterina;Camões, João;Campana, Valentine;Campbell, Paul;Campisi, Josie;Canepa, Cecilia;Cantero, Mireia;Caraux-Paz, Pauline;Cárcel, Sheila;Cardellino, Chiara Simona;Cardoso, Filipa;Cardoso, Filipe;Cardoso, Nelson;Cardoso, Sofia;Carelli, Simone;Carlacci, Francesca;Carlier, Nicolas;Carmoi, Thierry;Carney, Gayle;Carqueja, Inês;Carret, Marie-Christine;Carrier, François Martin;Carroll, Ida;Carson, Gail;Carvalho, Leonor;Casanova, Maire-Laure;Cascão, Mariana;Casey, Siobhan;Casimiro, José;Cassandra, Bailey;Castañeda, Silvia;Castanheira, Nidyanara;Castor-Alexandre, Guylaine;Castro, Ivo;Catarino, Ana;Catherine, François-Xavier;Cattaneo, Paolo;Cavalin, Roberta;Cavalli, Giulio Giovanni;Cavayas, Alexandros;Ceccato, Adrian;Cerkovnik, Shelby;Cervantes-Gonzalez, Minerva;Chair, Anissa;Chakveatze, Catherine;Chaleunphon, Bounthavy;Chan, Adrienne;Chand, Meera;Auger, Christelle Chantalat;Chapplain, Jean-Marc;Charpentier, Charlotte;Chas, Julie;Chatterjee, Allegra;Iñiguez, Jonathan Samuel Chávez;Chen, Anjellica;Chenard, Léo;Cheng, Matthew Pellan;Cheret, Antoine;Chetta, Alfredo Antonio;Chiarabini, Thibault;Chica, Julian;Chidambaram, Suresh Kumar;Tho, Leong Chin;Chirouze, Catherine;Chiumello, Davide;Cho, Hwa Jin;Cho, Sung-Min;Cholley, Bernard;Chommanam, Danoy;Chopin, Marie-Charlotte;Chow, Ting Soo;Chow, Yock Ping;Christy, Nathaniel;Chua, Hiu Jian;Chua, Jonathan;Cidade, Jose Pedro;Herreros, José Miguel Cisneros;Citarella, Barbara Wanjiru;Ciullo, Anna;Clarke, Emma;Clarke, Jennifer;Granado, Rolando Claure-Del;Clohisey, Sara;Codan, Cassidy;Cody, Caitriona;Coelho, Alexandra;Coles, Jennifer;Coles, Megan;Colin, Gwenhaël;Collins, Michael;S.M. Colombo;Combs, Pamela;Connor, Marie;Conrad, Anne;Contreras, Sofía;Conway, Elaine;Cooke, Graham S.;Copland, Mary;Cordel, Hugues;Corley, Amanda;Cornelis, Sabine;Cornet, Alexander Daniel;Corpuz, Arianne Joy;Cortegiani, Andrea;Corvaisier, Grégory;Costigan, Emma;Couffignal, Camille;Couffin-Cadiergues, Sandrine;Courtois, Roxane;Cousse, Stéphanie;Cregan, Rachel;D'Orleans, Charles Crepy;Cristella, Cosimo;Croonen, Sabine;Crowl, Gloria;Crump, Jonathan;Cruz, Claudina;Csete, Marc;Cullen, Ailbhe;Cummings, Matthew;Curley, Ger;Curlier, Elodie;Curran, Colleen;Custodio, Paula;da Silva Filipe, Ana;Da Silveira, Charlene;Dabaliz, Al-Awwab;Dagens, Andrew;Dahly, Darren;Dalton, Heidi;Dalton, Jo;Daly, Seamus;Damas, Juliana;Daneman, Nick;Daniel, Corinne;Dankwa, Emmanuelle A;Dantas, Jorge;D'Aragon, Frédérick;de Jong, Menno;de Loughry, Gillian;de Mendoza, Diego;De Montmollin, Etienne;de Oliveira França, Rafael Freitas;de Pinho Oliveira, Ana Isabel;De Rosa, Rosanna;De Rose, Cristina;de Silva, Thushan;de Vries, 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Zul;Faria, Pedro;Fateena, Hanan;Fatoni, Arie Zainul;Faure, Karine;Favory, Raphaël;Fayed, Mohamed;Feely, Niamh;Feeney, Laura;Fernandes, Jorge;Fernandes, Marília Andreia;Fernandes, Susana;Ferrand, François-Xavier;Devouge, Eglantine Ferrand;Ferrão, Joana;Ferrari, Carlo;Ferraz, Mário;Ferreira, Benigno;Ferreira, Bernardo;Ferreira, Isabel;Ferreira, Sílvia;Ferrer-Roca, Ricard;Ferriere, Nicolas;Ficko, Céline;Figueiredo-Mello, Claudia;Finlayson, William;Fiorda, Juan;Flament, Thomas;Flateau, Clara;Fletcher, Tom;Florence, Aline-Marie;Florio, Letizia Lucia;Flynn, Brigid;Flynn, Deirdre;Fogliazza, Federica;Foley, Claire;Foley, Jean;Fomin, Victor;Fonseca, Tatiana;Fontela, Patricia;Forsyth, Simon;Foster, Denise;Foti, Giuseppe;Fourn, Erwan;Fowler, Robert A.;Fraher, Marianne;Franch-Llasat, Diego;Fraser, Christophe;Fraser, John F;Freire, Marcela Vieira;Ribeiro, Ana Freitas;Friedrich, Caren;Fritz, Ricardo;Fry, Stéphanie;Fuentes, Nora;Fukuda, Masahiro;G, Argin;Gaborieau, Valérie;Gaci, Rostane;Gagliardi, 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Eibhlin;Higgins, Rupert;Hinchion, Rita;Hinton, Samuel;Hiraiwa, Hiroaki;Hirkani, Haider;Hitoto, Hikombo;Ho, Antonia;Ho, Yi Bin;Hoctin, Alexandre;Hoffmann, Isabelle;Hoh, Wei Han;Hoiting, Oscar;Holt, Rebecca;Holter, Jan Cato;Horby, Peter;Horcajada, Juan Pablo;Hoshino, Koji;Hoshino, Kota;Houas, Ikram;Hough, Catherine L.;Houltham, Stuart;Hsu, Jimmy Ming-Yang;Hulot, Jean-Sébastien;Huo, Stella;Hurd, Abby;Ijaz, Samreen;Ikram, M. Arfan;Illana, Carlos Cañada;Illes, Hajnal-Gabriela;Imbert, Patrick;Inácio, Hugo;Dominguez, Carmen Infante;Ing, Yun Sii;Iosifidis, Elias;Ippolito, Mariachiara;Irawany, Vera;Isgett, Sarah;Isidoro, Tiago;Ismail, Nadiah;Isnard, Margaux;Itai, Junji;Ito, Asami;Ivulich, Daniel;Jaafar, Danielle;Jaafoura, Salma;Jabot, Julien;Jackson, Clare;Jamieson, Nina;Janes, Victoria;Jaquet, Pierre;Jassat, Waasila;Jaud-Fischer, Coline;Jaureguiberry, Stéphane;Javidfar, Jeffrey;Jaworsky, Denise;Jego, Florence;Jelani, Anilawati Mat;Jenum, Synne;Jimbo-Sotomayor, Ruth;Joe, Ong Yiaw;García, Ruth N. 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Eduardo;Martins, Ana;Martins, João;Martins, Nuno;Rego, Caroline Martins;Martucci, Gennaro;Martynenko, Olga;Marwali, Eva Miranda;Marzukie, Marsilla;Jimenez, Juan Fernado Masa;Maslove, David;Mason, Sabina;Nor, Basri Mat;Matan, Moshe;Mathieu, Daniel;Mattei, Mathieu;Matulevics, Romans;Maulin, Laurence;Maxwell, Michael;Maynar, Javier;Mayxay, Mayfong;Mazzoni, Thierry;Sweeney, Lisa Mc;McCanny, Peter;McArthur, Colin;McCarthy, Aine;McCarthy, Anne;McCloskey, Colin;McConnochie, Rachael;McDermott, Sherry;McDonald, Sarah E.;McElroy, Aine;McElwee, Samuel;McEneany, Victoria;McEvoy, Natalie;McGeer, Allison;McKay, Chris;McKeown, Johnny;McLean, Kenneth A.;McNally, Paul;McNicholas, Bairbre;McPartlan, Elaine;Meaney, Edel;Mear-Passard, Cécile;Mechlin, Maggie;Mehkri, Omar;Mele, Ferruccio;Melo, Luis;Mendes, Joao Joao;Menkiti, Ogechukwu;Menon, Kusum;Mentré, France;Mentzer, Alexander J.;Mercier, Emmanuelle;Mercier, Noémie;Merckx, Antoine;Mergeay-Fabre, Mayka;Mergler, Blake;Merson, Laura;Meschi, Tiziana;Mesquita, António;Meta, Roberta;Metwally, Osama;Meybeck, Agnès;Meyer, Dan;Meynert, Alison M.;Meysonnier, Vanina;Meziane, Amina;Mezidi, Mehdi;Michelanglei, Céline;Michelet, Isabelle;Mihelis, Efstathia;Mihnovit, Vladislav;Miller, Jennene;Miranda-Maldonado, Hugo;Misnan, Nor Arisah;Mohamed, Nik Nur Eliza;Mohamed, Tahira Jamal;Moin, Asma;Molinos, Elena;Molloy, Brenda;Mone, Mary;Monteiro, Agostinho;Montes, Claudia;Montrucchio, Giorgia;Moore, Sarah;Moore, Shona C.;Cely, Lina Morales;Moro, Lucia;Morton, Ben;Motherway, Catherine;Motos, Ana;Mouquet, Hugo;Perrot, Clara Mouton;Moyet, Julien;Mudara, Caroline;Muh, Ng Yong;Muhamad, Dzawani;Mullaert, Jimmy;Müller, Fredrik;Müller, Karl Erik;Munblit, Daniel;Murphy, Aisling;Murphy, Lorna;Murris, Marlène;Murthy, Srinivas;Musaab, Himed;Mutti, Carlotta;Muvindi, Himasha;Muyandy, Gugapriyaa;Myrodia, Dimitra Melia;Mohd-Hanafiah, Farah Nadia;Nagpal, Dave;Nagrebetsky, Alex;Narasimhan, Mangala;Narayanan, Nageswaran;Nazerali-Maitland, Alasdair;Neant, Nadège;Neb, Holger;Necsoi, Coca;Nekliudov, Nikita;Nelwan, Erni;Neto, Raul;Neumann, Emily;Ng, Pauline Yeung;Nghi, Anthony;Nguyen, Duc;Choileain, Orna Ni;Leathlobhair, Niamh Ni;Nichol, Alistair D;Nitayavardhana, Prompak;Nonas, Stephanie;Noordin, Nurul Amani Mohd;Noret, Marion;Norharizam, Nurul Faten Izzati;Norman, Lisa;North, Anita;Notari, Alessandra;Noursadeghi, Mahdad;Nowicka, Karolina;Nowinski, Adam;Nseir, Saad;Nunez, Jose I;Nurnaningsih, Nurnaningsih;Nusantara, Dwi Utomo;Nyamankolly, Elsa;Brien, Fionnuala O;Callaghan, Annmarie O;O'Callaghan, Annmarie;Occhipinti, Giovanna;OConnor, Derbrenn;O'Donnell, Max;Ogston, Tawnya;Ogura, Takayuki;Oh, Tak-Hyuk;O'Halloran, Sophie;O'Hearn, Katie;Ohshimo, Shinichiro;Oldakowska, Agnieszka;Oliveira, João;Oliveira, Larissa;Olliaro, Piero L.;O'Neil, Conar;Ong, David S. Y.;Ong, Jee Yan;Oosthuyzen, Wilna;Opavsky, Anne;Openshaw, Peter;Orozco-Chamorro, Claudia Milena;Ortoleva, Jamel;Osatnik, Javier;O'Shea, Linda;O'Sullivan, Miriam;Othman, Siti Zubaidah;Ouamara, Nadia;Ouissa, Rachida;Oziol, Eric;Pagadoy, Maïder;Pages, Justine;Palacios, Amanda;Palmarini, Massimo;Panarello, Giovanna;Panda, Prasan Kumar;Pang, Lai Hui;Panigada, Mauro;Pansu, Nathalie;Papadopoulos, Aurélie;Parducci, Paolo;Oña, Edwin Fernando Paredes;Parke, Rachael;Parker, Melissa;Pasquier, Jérémie;Pastene, Bruno;Patauner, Fabian;Patel, Drashti;Pathmanathan, Mohan Dass;Patrão, Luís;Patricio, Patricia;Patrier, Juliette;Patrizi, Laura;Patterson, Lisa;Paul, Christelle;Paul, Mical;Paulos, Jorge;Paxton, William A.;Payen, Jean-François;Peake, Sandra L;Peariasamy, Kalaiarasu;Peek, Giles J.;Peelman, Florent;Peiffer-Smadja, Nathan;Peigne, Vincent;Pejkovska, Mare;Pelosi, Paolo;Peltan, Ithan D.;Pereira, Rui;Perez, Daniel;Periel, Luis;Perpoint, Thomas;Pesenti, Antonio;Pestre, Vincent;Petrou, Lenka;Petrovic, 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W.;Tveita, Anders;Twardowski, Pawel;Uchiyama, Makoto;Udayanga, PG Ishara;Udy, Andrew;Ullrich, Roman;Uribe, Alberto;Usman, Asad;Uyeki, Timothy M.;Vajdovics, Cristinava;Valentini, Piero;Val-Flores, Luís;Valran, Amélie;Valzano, Ilaria;de Velde, Stijn Van;Berge, Marcel van den;Feltz, Machteld Van der;Palen, Job van der;Valk, Paul van der;Vekens, Nicky Van Der;Voort, Peter Van der;Werf, Sylvie Van Der;Gulik, Laura van;Hattem, Jarne Van;Netten, Carolien van;Greve, Frank van Someren;Twillert, Gitte Van;Veen, Ilonka van;Willigen, Hugo Van;Vanel, Noémie;Vanoverschelde, Henk;Varghese, Pooja;Varrone, Michael;Vasudayan, Shoban Raj;Vauchy, Charline;Veeran, Shaminee;Veislinger, Aurélie;Vencken, Sebastian;Ventura, Sara;Verbon, Annelies;Vickers, James;Vidal, José Ernesto;Vieira, César;Villanueva, Joy Ann;Villar, Judit;Villeneuve, Pierre-Marc;Villoldo, Andrea;Chau, Nguyen Van Vinh;Vishwanathan, Gayatri;Visseaux, Benoit;Visser, Hannah;Vitiello, Chiara;Vongsouvath, Manivanh;Vonkeman, Harald;Vuotto, Fanny;Wahab, Noor Hidayu;Wahab, Suhaila Abdul;Wahid, Nadirah Abdul;Wainstein, Marina;Webb, Steve;Wei, Jia;Weil, Katharina;Wen, Tan Pei;Wesselius, Sanne;West, T. Eoin;Wham, Murray;Whelan, Bryan;Wicky, Paul Henri;Wiedemann, Aurélie;Wijaya, Surya Otto;Wille, Keith;Willems, Sue;Williams, Patricia J;Williams, Virginie;Wils, Evert-Jan;Yiu, Ng Wing;Wong, Calvin;Wong, Teck Fung;Wong, Xin Ci;Wong, Yew Sing;Wright, Natalie;Xian, Gan Ee;Xian, Lim Saio;Xuan, Kuan Pei;Xynogalas, Ioannis;Yacoub, Sophie;Yakop, Siti Rohani Binti Mohd;Yamazaki, Masaki;Yarad, Elizabeth;Yazdanpanah, Yazdan;Hing, Nicholas Yee Liang;Yelnik, Cécile;Yeoh, Chian Hui;Yerkovich, Stephanie;Yiaye, Touxiong;Yokoyama, Toshiki;Yonis, Hodane;Yousif, Obada;Yuliarto, Saptadi;Zaaqoq, Akram;Zabbe, Marion;Zabert, Gustavo E;Zacharowski, Kai;Zahid, Masliza;Zahran, Maram;Zaidan, Nor Zaila Binti;Zambon, Maria;Zambrano, Miguel;Zanella, Alberto;Zawadka, Konrad;Zaynah, Nurul;Zayyad, Hiba;Zoufaly, Alexander;Zucman, David;null, null

2024

Abstract

By September 2022, more than 600 million cases of SARS-CoV-2 infection have been reported globally, resulting in over 6.5 million deaths. COVID-19 mortality risk estimators are often, however, developed with small unrepresentative samples and with methodological limitations. It is highly important to develop predictive tools for pulmonary embolism (PE) in COVID-19 patients as one of the most severe preventable complications of COVID-19. Early recognition can help provide life-saving targeted anti-coagulation therapy right at admission. Using a dataset of more than 800,000 COVID-19 patients from an international cohort, we propose a cost-sensitive gradient-boosted machine learning model that predicts occurrence of PE and death at admission. Logistic regression, Cox proportional hazards models, and Shapley values were used to identify key predictors for PE and death. Our prediction model had a test AUROC of 75.9% and 74.2%, and sensitivities of 67.5% and 72.7% for PE and all-cause mortality respectively on a highly diverse and held-out test set. The PE prediction model was also evaluated on patients in UK and Spain separately with test results of 74.5% AUROC, 63.5% sensitivity and 78.9% AUROC, 95.7% sensitivity. Age, sex, region of admission, comorbidities (chronic cardiac and pulmonary disease, dementia, diabetes, hypertension, cancer, obesity, smoking), and symptoms (any, confusion, chest pain, fatigue, headache, fever, muscle or joint pain, shortness of breath) were the most important clinical predictors at admission. Age, overall presence of symptoms, shortness of breath, and hypertension were found to be key predictors for PE using our extreme gradient boosted model. This analysis based on the, until now, largest global dataset for this set of problems can inform hospital prioritisation policy and guide long term clinical research and decision-making for COVID-19 patients globally. Our machine learning model developed from an international cohort can serve to better regulate hospital risk prioritisation of at-risk patients.

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Scheda completa (DC)

	Settori scientifico-disciplinari dell'articolo (validi dal 09/05/2024)
	
				Settore MEDS-23/A - Anestesiologia
			
	Titolo del progetto
	
	Titolo Progetto
	
									EPSRC Centre for Doctoral Training in Health Data Science
								
	Nome finanziatore
	
										UK Research and Innovation
									
	Finanziamento
	
									EPSRC
								
	N. Contratto
	
									EP/S02428X/1
								
	Titolo Progetto
	
									Rapid European SARS-CoV-2 Emergency research Response
								
	Acronimo
	
									RECoVER
								
	Nome finanziatore
	
										European Commission
									
	Finanziamento
	
									Horizon 2020 Framework Programme
								
	N. Contratto
	
									101003589
								
	Titolo Progetto
	
									European Clinical Research Alliance on Infectious Diseases
								
	Acronimo
	
									ECRAID-Base
								
	Nome finanziatore
	
										European Commission
									
	Finanziamento
	
									Horizon 2020 Framework Programme
								
	N. Contratto
	
									965313
								
	Titolo Progetto
	
									Norwegian SARS-CoV-2 study – Virological, clinical and immunological characterisation of inpatients during the COVID-19 outbreak
								
	Nome finanziatore
	
										The Research Council of Norway
									
	Finanziamento
	
									BEHANDLING
								
	N. Contratto
	
									312780
								
	Titolo Progetto
	
									ARC Centres of Excellence - Grant ID: CE170100009
								
	Nome finanziatore
	
										Australian Research Council (ARC)
									
	Finanziamento
	
									ARC Centres of Excellence
								
	N. Contratto
	
									CE170100009
								
	Titolo Progetto
	
									ISARIC - Coronavirus Clinical Characterisation Consortium (ISARIC-4C)
								
	Nome finanziatore
	
										UK Research and Innovation
									
	Finanziamento
	
									MRC
								
	N. Contratto
	
									MC_PC_19059
								
	Data di pubblicazione
	
				lug-2024
			
	Rivista in ANCE
	
				SCIENTIFIC REPORTS
			
	DOI
	
				https://dx.doi.org/10.1038/s41598-024-63212-7
			
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				Article (author)
			
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				01 - Articolo su periodico

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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1190638

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