Influence of Co-morbidities During SARS-CoV-2 Infection in an Indian Population

Since the outbreak of COVID-19 pandemic the interindividual variability in the course of the disease has been reported, indicating a wide range of factors influencing it. Factors which were the most often associated with increased COVID-19 severity include higher age, obesity and diabetes. The influence of cytokine storm is complex, reflecting the complexity of the immunological processes triggered by SARS-CoV-2 infection. A modern challenge such as a worldwide pandemic requires modern solutions, which in this case is harnessing the machine learning for the purpose of analysing the differences in the clinical properties of the populations affected by the disease, followed by grading its significance, consequently leading to creation of tool applicable for assessing the individual risk of SARS-CoV-2 infection.

Biochemical and morphological parameters values of 5,000 patients (Curisin Healthcare (India) were gathered and used for calculation of eGFR, SII index and N/L ratio. Spearman's rank correlation coefficient formula was used for assessment of correlations between each of the features in the population and the presence of the SARS-CoV-2 infection. Feature importance was evaluated by fitting a Random Forest machine learning model to the data and examining their predictive value. Its accuracy was measured as the F1 Score.

The parameters which showed the highest correlation coefficient were age, random serum glucose, serum urea, gender and serum cholesterol, whereas the highest inverse correlation coefficient was assessed for alanine transaminase, red blood cells count and serum creatinine. The accuracy of created model for differentiating positive from negative SARS-CoV-2 cases was 97%. Features of highest importance were age, alanine transaminase, random serum glucose and red blood cells count.

The current analysis indicates a number of parameters available for a routine screening in clinical setting. It also presents a tool created on the basis of these parameters, useful for assessing the individual risk of developing COVID-19 in patients. The limitation of the study is the demographic specificity of the studied population, which might restrict its general applicability.