MarkerScout: A Disease-Agnostic Machine Learning Framework for Biomarker Prediction from Multi-Scale Mechanistic...

We demonstrate the framework on three infectious diseases derived from a companion mechanistic immune-simulation platform: SARS-CoV-2, Influenza A Virus, and Plasmodium falciparum. Each disease was evaluated across hospitalization and intensive care unit cohorts, yielding six cohorts in total. Best-pipeline cross-validated macro F1 ranged from 0.82 for IAV-HOSP to 0.99 for COV-ICU, and the framework produced tiered, direction-aware biomarker lists for each disease and phase. Interleukin-18 (IL-18) reached the strongest tier in both SARS-CoV-2 phases with consistent direction. When benchmarked against three separate, independently collected clinical ICU datasets, MarkerScout's top-ranked features outperformed 94.4% of randomly selected feature sets of equivalent size for SARS-CoV-2, with a weaker but directionally consistent advantage for Influenza A Virus (66.7%) and Plasmodium falciparum (60.7%).