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Open Forum Infect Dis . Machine Learning-Driven COVID-19 Hospitalization Forecasting: From Theory to Practice in a Major Northeastern Academic Medic

tetano

Editor, Senior Moderator
Open Forum Infect Dis


. 2025 Jun 12;12(6):ofaf307.
doi: 10.1093/ofid/ofaf307. eCollection 2025 Jun. Machine Learning-Driven COVID-19 Hospitalization Forecasting: From Theory to Practice in a Major Northeastern Academic Medical Center

Alexander Y Tulchinsky[SUP] 1 [/SUP], Xihan Zhao[SUP] 2 [/SUP], Nodar Kipshidze[SUP] 1 [/SUP], Jeremiah Hinson[SUP] 2 [/SUP], Fardad Haghpanah[SUP] 1 [/SUP], Eili Y Klein[SUP] 1 2 3 [/SUP]



Affiliations
Abstract

Background: Predicting seasonal and emerging waves of respiratory viruses is crucial for effective public health responses. Despite significant efforts in developing coronavirus disease 2019 (COVID-19) forecast models, there remains a need for improvement in model performances.
Methods: We developed and evaluated a machine learning model to forecast COVID-19 hospitalizations by extending the Neural Basis Expansion Analysis for Time Series Forecasting (N-BEATS) architecture. Specifically, we integrated a temporal convolutional network to incorporate exogenous variables and added additional residual blocks to create a variance-forecasting network component for probabilistic predictions. We compared the performance of our model to the ensemble models from the COVID-19 Forecast Hub. Additionally, we implemented the model in a large academic medical center, applying transfer learning to adapt the model to local hospitalization data.
Results: Our model demonstrated a 34.0% improvement in mean absolute error over the performance-weighted ensemble and 37.0% over the unweighted ensemble in predicting total US hospitalizations. Similar trends were obtained using mean absolute percent error and symmetric mean absolute percent error. In a real-world implementation, the model provided actionable forecasts for hospital leadership to optimize resource allocation and surge preparation.
Conclusions: The enhanced architecture significantly improves the forecasting of COVID-19 hospitalizations, particularly in anticipating peaks and resurgences. Its successful implementation in a hospital system highlights its potential for aiding decision-making and resource planning during pandemics and other respiratory disease outbreaks.

Keywords: COVID-19; N-BEATS; machine learning; public health; temporal convolutional network.

 
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