Profiling short-term longitudinal severity progression and associated genes in COVID-19 patients using EHR and single-cell analysis.

Publication date: Jul 01, 2025

Here we propose CovSF, a deep learning model designed to track and forecast short-term severity progression of COVID-19 patients using longitudinal clinical records. The motivation stems from the need for timely medical resource allocation, improved treatment decisions during pandemics, and the understanding of severity progression related immunology. The COVID-19 Severity Forecasting model, CovSF, utilizes 15 clinical features to profile the severity levels of hospital admitted patients and also forecast their severity levels of up to three days ahead. CovSF was trained on a large COVID-19 cohort (n=4,509), achieving an AUROC of 0. 92 with 0. 85 and 0. 89 sensitivity and specificity on an external validation dataset (n=443). The type of oxygen therapy administered was utilized as the target predictive label, which is often used as the severity index. This approach enables the inclusion of a more comprehensive dataset encompassing patients across the full spectrum of severity, rather than restricting the analysis to more narrowly defined outcomes such as ICU admission or mortality. We focused on profiling deteriorating and recovering health conditions, which were validated using patient matched single-cell transcriptomes. Especially, we showed that the immunology significantly differed between the samples during deterioration and recovery, whose severity levels were the same, and thus presenting the importance of longitudinal analysis. We believe that the framework of CovSF can be extended to other respiratory infectious diseases to alleviate the strain of allocating hospital resources, especially in pandemics.

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Concepts Keywords
Covid Aged
Immunology COVID-19
Pandemics Deep Learning
Therapy Deep learning
Disease Progression
Electronic Health Records
Female
Humans
Longitudinal Studies
Male
Middle Aged
Progression
SARS-CoV-2
Severity
Single-cell
Single-Cell Analysis
Time course
Transcriptome

Semantics

Type Source Name
disease MESH COVID-19
disease IDO cell
drug DRUGBANK Oxygen
disease MESH infectious diseases
disease MESH Long Covid
disease IDO blood
drug DRUGBANK Coenzyme M
disease MESH respiratory diseases
disease MESH critically ill
disease IDO intervention
disease MESH infection
disease MESH pneumonia
drug DRUGBANK Urea
drug DRUGBANK Nitrogen
drug DRUGBANK Creatinine
drug DRUGBANK Medical air
disease MESH Disease Progression

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