Predicting COVID-19 severity in pediatric patients using machine learning: a comparative analysis of algorithms and ensemble methods

COVID-19 has posed a significant global health challenge, affecting individuals across all age groups. While extensive research has focused on adults, pediatric patients exhibit distinct clinical characteristics that necessitate specialized predictive models for disease severity. Machine learning offers a powerful approach to analyzing complex datasets and predicting outcomes, yet its application in pediatric COVID-19 remains limited. This study evaluates the performance of machine learning algorithms in predicting disease severity among pediatrics. A retrospective analysis was conducted on a dataset of 588 pediatric with confirmed COVID-19, incorporating demographic, clinical, and laboratory variables. Various machine learning models were trained and assessed, with a SuperLearner ensemble model implemented to enhance predictive accuracy. Among the models, Random Forest exhibited the highest performance, achieving an accuracy of 90.1%, sensitivity of 90.2%, and specificity of 90.1%. The SuperLearner ensemble further improved predictive performance, demonstrating the lowest mean risk estimate. Key predictors, including oxygen saturation, respiratory parameters, and specific laboratory markers, played a crucial role in distinguishing severe from non-severe cases. These findings emphasize the potential of machine learning, particularly ensemble methods, in improving risk stratification for pediatric COVID-19. Integrating these predictive models into clinical practice could support early identification of high-risk patients and optimize clinical decision-making.