Clinical longitudinal evaluation of COVID-19 patients and prediction of organ specific recovery using artificial intelligence

Wang, Winston T; Zhang, Charlotte L; Wei, Kang; Sang, Ye; Shen, Jun; Wang, Guangyu; Lozano, Alexander X

Within COVID-19 there is an urgent unmet need to predict at the time of hospital admission which patients will recover from the disease, and how fast they recover in order to deliver personalized treatments and to properly allocate hospital resources so that healthcare systems do not become overwhelmed. To this end we have combined clinically salient CT imaging data synergistically with laboratory testing data in an integrative machine learning model to predict organ-specific recovery of patients from COVID-19. We trained and validated our model in 285 patients on each separate major organ system impacted by COVID-19 including the renal, pulmonary, immune, cardiac, and hepatic systems. To greatly enhance the speed and utility of our model, we applied an artificial intelligence method to segment and classify regions on CT imaging, from which interpretable data could be directly fed into the predictive machine learning model for overall recovery. Across all organ systems we achieved validation set area under the receiver operator characteristic curve (AUC) values for organ-specific recovery ranging from 0.80 to 0.89, and significant overall recovery prediction in Kaplan-Meier analyses. This demonstrates that the synergistic use of an AI framework applied to CT lung imaging and a machine learning model that integrates laboratory test data with imaging data can accurately predict the overall recovery of COVID-19 patients from baseline characteristics.