Symptom-Based Predictive Model of COVID-19 Disease in Children

Viruses. 2021 Dec 30;14(1):63. doi: 10.3390/v14010063.


Background: Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is neither always accessible nor easy to perform in children. We aimed to propose a machine learning model to assess the need for a SARS-CoV-2 test in children (<16 years old), depending on their clinical symptoms.

Methods: Epidemiological and clinical data were obtained from the REDCap® registry. Overall, 4434 SARS-CoV-2 tests were performed in symptomatic children between 1 November 2020 and 31 March 2021, 784 were positive (17.68%). We pre-processed the data to be suitable for a machine learning (ML) algorithm, balancing the positive-negative rate and preparing subsets of data by age. We trained several models and chose those with the best performance for each subset.

Results: The use of ML demonstrated an AUROC of 0.65 to predict a COVID-19 diagnosis in children. The absence of high-grade fever was the major predictor of COVID-19 in younger children, whereas loss of taste or smell was the most determinant symptom in older children.

Conclusions: Although the accuracy of the models was lower than expected, they can be used to provide a diagnosis when epidemiological data on the risk of exposure to COVID-19 is unknown.

Keywords: COVID-19; SARS-CoV-2; deep learning; epidemiology; machine learning; microbiology; paediatrics.

MeSH terms

  • Adolescent
  • COVID-19 / diagnosis*
  • COVID-19 / epidemiology
  • COVID-19 Testing / methods*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Machine Learning
  • Male
  • Models, Statistical
  • Predictive Value of Tests
  • SARS-CoV-2 / isolation & purification*