• Varun Arvind, Jun S Kim, Brian H Cho, Eric Geng, and Samuel K Cho.
• Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States of America.
• J Crit Care. 2021 Apr 1; 62: 253025-30.

PurposeThe purpose of this study is to develop a machine learning algorithm to predict future intubation among patients diagnosed or suspected with COVID-19.Materials And MethodsThis is a retrospective cohort study of patients diagnosed or under investigation for COVID-19. A machine learning algorithm was trained to predict future presence of intubation based on prior vitals, laboratory, and demographic data. Model performance was compared to ROX index, a validated prognostic tool for prediction of mechanical ventilation.Results4087 patients admitted to five hospitals between February 2020 and April 2020 were included. 11.03% of patients were intubated. The machine learning model outperformed the ROX-index, demonstrating an area under the receiver characteristic curve (AUC) of 0.84 and 0.64, and area under the precision-recall curve (AUPRC) of 0.30 and 0.13, respectively. In the Kaplan-Meier analysis, patients alerted by the model were more likely to require intubation during their admission (p < 0.0001).ConclusionIn patients diagnosed or under investigation for COVID-19, machine learning can be used to predict future risk of intubation based on clinical data which are routinely collected and available in clinical setting. Such an approach may facilitate identification of high-risk patients to assist in clinical care.Copyright © 2020. Published by Elsevier Inc.

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