Personalized Assessment of Mortality Risk and Hospital Stay Duration in Hospitalized Patients with COVID-19 Treated with Remdesivir: A Machine Learning Approach

Abstract

Background: Despite advancements in vaccination, early treatments, and understanding of SARS-CoV-2, its impact remains significant worldwide. Many patients require intensive care due to severe COVID-19. Remdesivir, a key treatment option among viral RNA polymerase inhibitors, lacks comprehensive studies on factors associated with its effectiveness. Methods: We conducted a retrospective study in 2022, analyzing data from 252 hospitalized COVID-19 patients treated with remdesivir. Six machine learning algorithms were compared to predict factors influencing remdesivir’s clinical benefits regarding mortality and hospital stay. Results: The extreme gradient boost (XGB) method showed the highest accuracy for both mortality (95.45%) and hospital stay (94.24%). Factors associated with worse outcomes in terms of mortality included limitations in life support, ventilatory support needs, lymphopenia, low albumin and hemoglobin levels, flu and/or coinfection, and cough. For hospital stay, factors included vaccine doses, lung density, pulmonary radiological status, comorbidities, oxygen therapy, troponin, lactate dehydrogenase levels, and asthenia. Conclusions: These findings underscore XGB’s effectiveness in accurately categorizing COVID-19 patients undergoing remdesivir treatment.

On the Generalizability of Machine Learning Classification Algorithms and Their Application to the Framingham Heart Study

“…Machine learning comparative studies, which include extreme gradient boosting, support vector machine, linear discriminant analysis, random forest and logistic regression, are starting to gain traction in predictive modeling for healthcare-for instance, regarding the risk of stroke [54], knee osteoarthritis diagnosis [55] and mortality risk and hospital stay duration in hospitalized patients with COVID-19 treated with Remdesivir [56]. The latter two works showed that extreme gradient boosting provided the highest accuracy.…”