Automatic identification of risk factors for SARS-CoV-2 positivity and severe clinical outcomes of COVID-19 using Data Mining and Natural Language Processing

ObjectivesSeveral risk factors have been identified for severe clinical outcomes of COVID-19 caused by SARS-CoV-2. Some can be found in structured data of patients Electronic Health Records. Others are included as unstructured free-text, and thus cannot be easily detected automatically. We propose an automated real-time detection of risk factors using a combination of data mining and Natural Language Processing (NLP). Material and methodsPatients were categorized as negative or positive for SARS-CoV-2, and according to disease severity (severe or non-severe COVID-19). Comorbidities were identified in the unstructured free-text using NLP. Further risk factors were taken from the structured data. Results6250 patients were analysed (5664 negative and 586 positive; 461 non-severe and 125 severe). Using NLP, comorbidities, i.e. cardiovascular and pulmonary conditions, diabetes, dementia and cancer, were automatically detected (error rate [&le;]2%). Old age, male sex, higher BMI, arterial hypertension, chronic heart failure, coronary heart disease, COPD, diabetes, insulin only treatment of diabetic patients, reduced kidney and liver function were risk factors for severe COVID-19. Interestingly, the proportion of diabetic patients using metformin but not insulin was significantly higher in the non-severe COVID-19 cohort (p<0.05). Discussion and conclusionOur findings were in line with previously reported risk factors for severe COVID-19. NLP in combination with other data mining approaches appears to be a suitable tool for the automated real-time detection of risk factors, which can be a time saving support for risk assessment and triage, especially in patients with long medical histories and multiple comorbidities.