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Real-time prediction of COVID-19 related mortality using electronic health records

Patrick Schwab, Arash Mehrjou, Sonali Parbhoo, Leo Anthony Celi, Jürgen Hetzel, Markus Hofer, Bernhard Schölkopf, Stefan Bauer

2021Nature Communications55 citationsDOIOpen Access PDF

Abstract

Coronavirus disease 2019 (COVID-19) is a respiratory disease with rapid human-to-human transmission caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Due to the exponential growth of infections, identifying patients with the highest mortality risk early is critical to enable effective intervention and prioritisation of care. Here, we present the COVID-19 early warning system (CovEWS), a risk scoring system for assessing COVID-19 related mortality risk that we developed using data amounting to a total of over 2863 years of observation time from a cohort of 66 430 patients seen at over 69 healthcare institutions. On an external cohort of 5005 patients, CovEWS predicts mortality from 78.8% (95% confidence interval [CI]: 76.0, 84.7%) to 69.4% (95% CI: 57.6, 75.2%) specificity at sensitivities greater than 95% between, respectively, 1 and 192 h prior to mortality events. CovEWS could enable earlier intervention, and may therefore help in preventing or mitigating COVID-19 related mortality.

Topics & Concepts

MedicineCohortConfidence intervalDiseaseCohort studyEmergency medicineTransmission (telecommunications)Risk assessmentRelative riskRisk of mortalityHealth careIntensive care medicineProportional hazards modelCoronavirus disease 2019 (COVID-19)Warning systemEpidemiologyCoronavirusEarly warning scoreHealth recordsEarly warning systemMedical recordEnvironmental healthMortality rateMedical emergencyPediatricsSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)Intervention (counseling)MEDLINESeverity of illnessRetrospective cohort studyElectronic health recordMachine Learning in HealthcareCOVID-19 diagnosis using AICOVID-19 epidemiological studies
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