Fine-Grained Assessment of COVID-19 Severity Based on Clinico-Radiological Data Using Machine Learning

Haipeng Liu, Jiangtao Wang, Yayuan Geng, Kunwei Li, Han Wu, Jian Chen, Xiangfei Chai, Shaolin Li, Dingchang Zheng

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    3 Citations (Scopus)
    25 Downloads (Pure)


    Background: The severe and critical cases of COVID-19 had high mortality rates. Clinical features, laboratory data, and radiological features provided important references for the assessment of COVID-19 severity. The machine learning analysis of clinico-radiological features, especially the quantitative computed tomography (CT) image analysis results, may achieve early, accurate, and fine-grained assessment of COVID-19 severity, which is an urgent clinical need. Objective: To evaluate if machine learning algorithms using CT-based clinico-radiological features could achieve the accurate fine-grained assessment of COVID-19 severity. Methods: The clinico-radiological features were collected from 78 COVID-19 patients with different severities. A neural network was developed to automatically measure the lesion volume from CT images. The severity was clinically diagnosed using two-type (severe and non-severe) and fine-grained four-type (mild, regular, severe, critical) classifications, respectively. To investigate the key features of COVID-19 severity, statistical analyses were performed between patients’ clinico-radiological features and severity. Four machine learning algorithms (decision tree, random forest, SVM, and XGBoost) were trained and applied in the assessment of COVID-19 severity using clinico-radiological features. Results: The CT imaging features (CTscore and lesion volume) were significantly related with COVID-19 severity (p 0.05 in statistical analysis for both in two-type and fine-grained four-type classifications). The CT imaging features significantly improved the accuracy of machine learning algorithms in assessing COVID-19 severity in the fine-grained four-type classification. With CT analysis results added, the four-type classification achieved comparable performance to the two-type one. Conclusion: CT-based clinico-radiological features can provide an important reference for the accurate fine-grained assessment of illness severity using machine learning to achieve the early triage of COVID-19 patients.
    Original languageEnglish
    Article number10665
    Pages (from-to)10665
    Number of pages14
    JournalInternational Journal of Environmental Research and Public Health
    Issue number17
    Publication statusPublished - 26 Aug 2022

    Bibliographical note

    This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


    • COVID-19
    • lesion volume measurement
    • clinico-radiological features
    • machine learning
    • fine-grained classification


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