In a groundbreaking effort to transform patient management and optimize healthcare resource allocation during severe viral outbreaks, a cutting-edge platform harnessing the power of machine learning and metabolomics data has been unveiled. This innovative approach aims to alleviate the strain on local healthcare systems, which often become overwhelmed during epidemics. Metabolomics, a branch of science focused on investigating small molecules associated with cellular metabolism, plays a pivotal role in this endeavor.

According to the senior author of the study, Vasilis Vasiliou, a professor of epidemiology at Yale University School of Public Health, “Being able to predict which patients can be sent home and those possibly needing intensive care unit admission is critical for health officials seeking to optimize patient health outcomes and use hospital resources most efficiently during an outbreak.”

The research team behind this groundbreaking development has created a platform that seamlessly integrates routine clinical data, patient comorbidity information, and untargeted plasma metabolomics data. Their primary focus was on using COVID-19 as a disease model to demonstrate the platform’s capabilities.

Lead author Georgia Charkoftaki, an associate research scientist in the environmental health sciences department, highlights the distinctiveness of their AI-powered patient triage platform, stating, “Our AI-powered patient triage platform is distinct from typical COVID-19 AI prediction models. It serves as the cornerstone for a proactive and methodical approach to addressing upcoming viral outbreaks.”

Using machine learning techniques, the researchers constructed a comprehensive model for COVID-19 severity and the prediction of hospitalization based on data collected from patients hospitalized with the disease. Their model identified a panel of unique clinical and metabolic biomarkers that proved highly indicative of disease progression and enabled the early prediction of patient management needs shortly after hospitalization.

To validate their findings, the researchers collected extensive data from 111 COVID-19 patients admitted to Yale New Haven Hospital over a two-month period in 2020. Additionally, they included 342 healthy individuals (healthcare workers) as controls. These patients were categorized into different groups based on their treatment requirements, ranging from those not needing external oxygen to those requiring positive airway pressure or intubation.

The study revealed several elevated metabolites in plasma that exhibited a distinct correlation with COVID-19 severity, including allantoin, 5-hydroxy tryptophan, and glucuronic acid. Notably, elevated blood eosinophil levels were identified as a potential new biomarker for assessing COVID-19 severity. Moreover, patients requiring positive airway pressure or intubation displayed decreased plasma serotonin levels, a surprising discovery that warrants further investigation.

The AI-assisted patient triage platform comprises three essential components:

  1. Clinical Decision Tree: This precision medicine tool incorporates key biomarkers for disease prognosis to provide real-time predictions of disease progression and the potential duration of a patient’s hospital stay. The tested predictive model demonstrated high accuracy in the study.
  2. Hospitalization Estimation: The platform successfully estimated the length of patient hospitalization within a 5-day margin of error. Key factors influencing this estimation included respiratory rate (>18 breaths/minute) and minimum blood urea nitrogen (BUN), a byproduct of protein metabolism.
  3. Disease Severity Prediction: The platform reliably predicted disease severity and the likelihood of a patient being admitted to an intensive care unit. This helps healthcare providers identify patients most at risk of developing life-threatening illnesses and allows them to begin treatments quickly to optimize outcomes.

As an integral part of their research, the team developed user-friendly software known as the “COVID Severity by Metabolomic and Clinical Study (CSMC) software.” This software seamlessly integrates machine learning and clinical data to provide pre-hospital patient management and classify patients’ conditions upon their arrival at the emergency department.

Vasiliou, the professor of epidemiology, emphasizes the broad implications of their work, stating, “Our model platform provides a personalized approach for managing COVID-19 patients, but it also lays the groundwork for future viral outbreaks. As the world continues to grapple with COVID-19 and we remain vigilant against potential future outbreaks, our AI-powered platform represents a promising step towards a more effective and data-driven public health response.”

However, it’s important to acknowledge certain limitations of the study. All samples were collected between March and May 2020, a period predating the emergence of COVID-19 vaccines and advanced treatments. Consequently, the observed changes in metabolite biomarkers may have been influenced by these factors. Additionally, the study population of healthy controls was predominantly of one ethnicity, while the COVID-19 patients included a higher proportion of individuals from a different ethnic background, suggesting the possibility

By Impact Lab