Deep Learning–Based Time-to-Death Prediction Model for COVID-19 Patients Using Clinical Data and Chest Radiographs

Accurate estimation of mortality and time to death at admission for COVID-19 patients is important and several deep learning models have been created for this task. However, there are currently no prognostic models which use end-to-end deep learning to predict time to event for admitted COVID-19 patients using chest radiographs and clinical data. We retrospectively implemented a new artificial intelligence model combining DeepSurv (a multiple-perceptron implementation of the Cox proportional hazards model) and a convolutional neural network (CNN) using 1356 COVID-19 inpatients. For comparison, we also prepared DeepSurv only with clinical data, DeepSurv only with images (CNNSurv), and Cox proportional hazards models. Clinical data and chest radiographs at admission were used to estimate patient outcome (death or discharge) and duration to the outcome. The Harrel’s concordance index (c-index) of the DeepSurv with CNN model was 0.82 (0.75–0.88) and this was significantly higher than the DeepSurv only with clinical data model (c-index = 0.77 (0.69–0.84), p = 0.011), CNNSurv (c-index = 0.70 (0.63–0.79), p = 0.001), and the Cox proportional hazards model (c-index = 0.71 (0.63–0.79), p = 0.001). These results suggest that the time-to-event prognosis model became more accurate when chest radiographs and clinical data were used together.