Machine learning models predict long COVID outcomes based on baseline clinical and immunologic factors

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Authors: Naresh Doni Jayavelu, Hady Samaha, S. Wimalasena, Annmarie Hoch, Jeremy P. Gygi, Gisela Gabernet, Al Ozonoff, Shanshan Liu, Carly E. Milliren, Ofer Levy, Lindsey R. Baden, Esther Melamed
+88 more Lauren I. R. Ehrlich, Grace A. McComsey, R.P. Sékaly, Charles B. Cairns, Elias K. Haddad, Joanna Schaenman, Albert C. Shaw, David A. Hafler, Ruth R. Montgomery, David B. Corry, F. Kheradmand, Mark A. Atkinson, Scott C. Brakenridge, Nelson I. Agudelo Higuit, Jordan P. Metcalf, Catherine L. Hough, William B. Messer, Bali Pulendran, Kari C. Nadeau, Mark Davis, Linda N. Geng, Ana Fernandez Sesma, Viviana Simon, Florian Krammer, Monica Kraft, Chris Bime, Carolyn S. Calfee, David J. Erle, Charles Langelier, IMPACC Network, Patrice M. Becker, Alison D. Augustine, Steven M. Holland, Lindsey B. Rosen, Serena Lee, Tatyana Vaysman, Jing Chen, Alvin T. Kho, Ana C. Chang, Kerry McEnaney, Brenda Barton, Claudia Lentucci, Maimouna D. Murphy, Mehmet Saluvan, Tanzia Shaheen, Caitlin Syphurs, Marisa S. Albert, Arash Nemati Hayati, Robert W. Bryant, James Abraham, Sanya Thomas, Mitchell Cooney, Meagan Karoly, Scott Presnell, Bernard Kohr, Tomasz Jancsyk, Azlann Arnett, James A. Overton, Randi Vita, Kerstin Westendorf, James A. Overton, Hanno Steen, Patrick van Zalm, Benoit Fatou, Kinga K. Smolen, Arthur Viodé, Simon van Haren, Meenakshi Jha, David K. Stevenson, Kevin Mendez, Jessica Lasky‐Su, Alexandra Tong, Rebecca Rooks, Michaël Desjardins, Amy C Sherman, Stephen R. Walsh, Xhoi Mitre, Jessica Cauley, Xiofang Li, Bethany Evans, Christina Montesano, Jose Humberto Licona, Jonathan Krauß, Nicolas C. Issa, Jun Bai Park Chang, Natalie Izaguirre, Scott R. Hutton, Greg Michelotti
Cited by: 3
References: 36

Abstract

The post-acute sequelae of SARS-CoV-2 (PASC), also known as long COVID, remain a significant health issue that is incompletely understood. Predicting which acutely infected individuals will develop long COVID is challenging due to the absence of established biomarkers, clear disease mechanisms, or well-defined sub-phenotypes. Machine learning (ML) models may address this gap by leveraging clinical data to enhance diagnostic precision. Clinical data, including antibody titers and viral load measurements collected at the time of hospital admission, are used to predict the likelihood of acute COVID-19 progressing to long COVID. Machine learning models are trained and evaluated for predictive performance. Feature importance analysis is performed to identify the most influential predictors. The machine learning models achieve median AUROC values ranging from 0.64 to 0.66 and AUPRC values between 0.51 and 0.54, demonstrating predictive capabilities. Low antibody titers and high viral loads at hospital admission emerge as the strongest predictors of long COVID outcomes. Comorbidities—such as chronic respiratory, cardiac, and neurologic diseases—and female sex are also identified as significant risk factors. Machine learning models identify patients at risk for developing long COVID based on baseline clinical characteristics. These models guide early interventions, improve patient outcomes, and mitigate the long-term public health impacts of SARS-CoV-2. Long COVID, or post-acute sequelae of SARS-CoV-2, is a prolonged health condition that can occur after acute COVID-19 infection. However, the ability to predict who will develop long COVID remains limited due to the absence of clear tests or biomarkers. We looked at patients’ medical information, including the amount of virus in their body at hospital admission, and how strong their immune response was. Using computer programs that can find hidden patterns in large sets of data, we discovered that people with a weaker immune response, higher amounts of virus, certain long term health problems and women are more likely to develop long COVID. This study highlights that computer-based tools could help doctors identify high-risk patients early and provide care that may prevent long-term complications. Jayavelu, Samaha et al., apply machine learning models on hospital admission data, including antibody titers and viral load, to identify patients at high risk for Long COVID. Low antibody levels, high viral loads, chronic diseases, and female sex are key predictors, supporting early, targeted interventions.

Fields of Study & Subjects

Long-Term Effects of COVID-19 COVID-19 Clinical Research Studies Immune responses and vaccinations

Publication details

Journal / source
Communications Medicine
Publisher
Springer Science and Business Media LLC
Volume
6
Issue
1
Pages
1–1
Publication date
3 January 2026
Language
EN