Machine Learning-Based Prediction Models for the Prognosis of COVID-19 Patients with DKA

Abstract Patients with Diabetic ketoacidosis (DKA) have increased critical illness and mortality during coronavirus diseases 2019 (COVID-19). The aim of our study try to develop a predictive model for the occurrence of critical illness and mortality in COVID-19 patients with DKA utilizing machine learning. Blood samples and clinical data from 242 COVID-19 patients with DKA collected from December 2022 to January 2023 at Second Xiangya Hospital. Patients were categorized into non-death (n = 202) and death (n = 38) groups, and non-severe (n = 146) and severe (n = 96) groups. We developed five machine learning-based prediction models—Extreme Gradient Boosting (XGB), Logistic Regression (LR), Logistic Regression (RF), Support Vector Machine (SVM), and Multilayer Perceptron (MLP)—to evaluate the prognosis of COVID-19 patients with DKA. We employed 5-fold cross-validation for model evaluation and used the Shapley Additive Explanations (SHAP) algorithm for result interpretation to ensure reliability. The LR model demonstrated the highest accuracy (AUC = 0.933) in predicting mortality. Additionally, the LR model excelled (AUC = 0.898) in predicting progression to severe disease. This study successfully developed a machine learning-based prediction model for the prognosis of COVID-19 patients with DKA, demonstrating high predictive accuracy and clinical utility. This model can serve as a valuable tool in guiding the development of clinical treatments.