Abstract

Early prediction of mortality and risk of deterioration in COVID-19 patients can reduce mortality and increase the opportunity for better and more timely treatment. In the current study, the DL model and explainable artificial intelligence (EAI) were combined to identify the impact of certain attributes on the prediction of mortality and ventilatory support in COVID-19 patients. Nevertheless, the DL model does not suffer from the curse of dimensionality, but in order to identify significant attributes, the EAI feature importance method was used. The DL model produced significant results; however, it lacks interpretability. The study was performed using COVID-19-hospitalized patients in King Abdulaziz Medical City, Riyadh. The dataset contains the patients’ demographic information, laboratory investigations, and chest X-ray (CXR) findings. The dataset used suffers from an imbalance; therefore, balanced accuracy, sensitivity, specificity, Youden index, and AUC measures were used to investigate the effectiveness of the proposed model. Furthermore, the experiments were conducted using original and SMOTE (over and under sampled) datasets. The proposed model outperforms the baseline study, with a balanced accuracy of 0.98 and an AUC of 0.998 for predicting mortality using the full-feature set. Meanwhile, for predicting ventilator support a highest balanced accuracy of 0.979 and an AUC of 0.981 was achieved. The proposed explainable prediction model will assist doctors in the early prediction of COVID-19 patients that are at risk of mortality or ventilatory support and improve the management of hospital resources.

Highlights

  • Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) known as COVID-19, was first diagnosed in China in late 2019

  • In the k-fold cross-validation, the dataset is initially divided into k-segments, where (k − 1) segments are used to train the model and one segment to test in each iteration

  • The current study investigated the application of the deep learning (DL) model to predict mortality and the need for ventilator support in COVID-19 patients

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Summary

Introduction

Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) known as COVID-19, was first diagnosed in China in late 2019. Since it has infected around 222 countries worldwide and as of 7 January 2022, the total number of cases is approximately 301,121,144, including 92,107 patients in critical condition [1]. The probability of severe cases in patients is not high, sometimes a moderate-stage patient may quickly experience serious complications and need immediate hospitalization and intensive care. Because of this uncertainty, hospitals are sometimes confronted with a huge number of COVID-19-critical patients requiring ventilator support. Due to the unpredictable nature of COVID-19 [2], it is very crucial to develop an early warning system to predict which patients will deteriorate

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