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Updated: Nov 2, 2025

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Predicting Prolonged Hospitalization and Supplemental Oxygenation in Patients with COVID-19 Infection from Ambulatory

Ayis Pyrros1, Adam Eugene Flanders2, Jorge Mario Rodríguez-Fernández3

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Academic Radiology
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Deep learning analysis of chest X-rays can predict COVID-19 hospitalization risk in outpatients. This approach identifies patients needing supplemental oxygen, improving clinical prognosis prediction for coronavirus disease 2019.

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Area of Science:

  • Radiology and Medical Imaging
  • Artificial Intelligence in Medicine
  • Infectious Diseases

Background:

  • Predicting clinical outcomes for outpatients with COVID-19 is challenging.
  • Outcomes range from asymptomatic infection to severe disease requiring hospitalization or death.

Purpose of the Study:

  • To evaluate the prognostic value of outpatient chest radiographs.
  • To utilize deep learning algorithms for predicting comorbidities and airspace disease.
  • To identify patients at higher risk of hospitalization due to COVID-19.

Main Methods:

  • Retrospective study of 413 outpatients with COVID-19 confirmed by PCR.
  • Ambulatory chest radiography analyzed using deep learning models.
  • Machine learning algorithms assessed prediction of hospitalization (>2 days with oxygen).

Main Results:

  • A boosted decision tree model achieved an AUC of 0.837 (95% CI: 0.791-0.883).
  • Key predictors included age, morbid obesity, heart failure, arrhythmias, and radiographic opacity.
  • 12.3% of patients required hospitalization with supplemental oxygen.

Conclusions:

  • Deep learning on chest radiographs can predict hospitalization risk in COVID-19 outpatients.
  • Combined comorbidity and pneumonia scores are generated.
  • This method may aid in identifying patients needing supplemental oxygen and hospitalization.