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Öğe Association between COMT gene rs165599 SNP and schizophrenia: A meta-analysis of case-control studies(Wiley, 2018) Bag, Harika Gozde GozukaraBackgroundThere are many studies with different results that examine the association between Catechol-O-MethylTransferase (COMT) gene single-nucleotide polymorphisms (SNPs) and schizophrenia. In this study, the aim was to conduct a meta-analysis to achieve a pooled effect size of the association between COMT gene rs165599 SNP and schizophrenia. MethodsOdds ratio (OR) was used as an effect size to determine the association between schizophrenia and the SNP. The pooled ORs were achieved under four different genetic models. When the heterogeneity among studies was high the DerSimonian-Laird random-effects model, otherwise the Mantel-Haenszel fixed-effects model was used. Publication bias was evaluated by Egger's test. ResultsUnder different genetic models no statistically significant association was found between rs165599 SNP and schizophrenia by meta-analyses consist of 20 independent studies. There was high heterogeneity among studies, for the possible reason the population differences, although the subgroup analyzes reduced the heterogeneity, no association was obtained. However, the sex-specific estimation of the females showed that to be a G allele carrier is a risk factor for schizophrenia (OR=1.366 [95% confidence interval=1.094-1.706]) compared to AA homozygous. ConclusionThe COMT gene rs165599 SNP does not appear to be a single-risk factor for schizophrenia.Öğe CAD/CAM single-retainer monolithic zirconia ceramic resin-bonded fixed partial dentures bonded with two different resin cements: Up to 40 months clinical results of a randomized-controlled pilot study(Wiley, 2022) Bilir, Halenur; Yuzbasioglu, Emir; Sayar, Gulsilay; Kilinc, Delal Dara; Bag, Harika Gozde Gozukara; Ozcan, MutluPurpose This pilot study was part of a larger study planned for the future which aimed to compare the clinical success of two different resin cements used in the cementation of CAD/CAM single-retainer monolithic zirconia ceramic resin-bonded fixed dentures (RBFPDs). Methods Twenty-four RBFPDs were fabricated with monolithic zirconia (Katana (TM) Zirconia HT, Kuraray Noritake Dental Inc, Tokyo, Japan). Panavia F2.0 (PF2.0; n = 12) and Panavia V5 (PV5; n = 12) were used for cementation. The survival period was defined as the time when the restoration was placed in the mouth and lasted until an irreparable damage occurred. The repairable failures were identified as relative and irreparable failures were identified as absolute failure. The survival rate of the RBFPDs was determined by the Kaplan-Meier estimator. Statistical significance was set at p < 0.05. Results The mean observation times of the PF2.0 group and the PV5 group were 40.45 +/- 6.15 months and 40.18 +/- 6.41 months, respectively. Four failures occurred in the PF2.0 group. No failure was observed in the PV5 group. The curves of survival rate (PF2.0 = 80%, PV5 = 100%) showed no statistically significant difference (p = 0.031), although success rate (PF2.0 = 66.7%, PV5 = 100%) showed statistically significant difference (p = 0.317). Conclusion Up to 40 months mean follow-up period, performance of RBFPDs bonded with PV5 was better than with PF2.0. Clinical Significance For clinicians, it is a matter of hesitation to apply single-retainer RBFPDs. This study contains results of 40 months (minimum 32, maximum 50.47 months) clinical follow-ups of single-retainer RBFPDs. These results will enlighten clinicians about the clinical success of the resin cement type for single-retainer monolithic zirconia ceramic RBFPDs.Öğe Comparison of Nd:YAG laser (532 nm green) vs diode laser (810 nm) photocoagulation in the treatment of retinopathy of prematurity: an evaluation in terms of complications(Springer London Ltd, 2020) Dikci, Seyhan; Demirel, Soner; Firat, Penpe Gul; Yilmaz, Turgut; Ceylan, Osman Melih; Bag, Harika Gozde GozukaraPurpose To compare the anterior and posterior segment complications of diode (810 nm) laser photocoagulation (LPC) and Nd:YAG (532 nm green) LPC in the treatment of retinopathy of prematurity (ROP). Patients and methods The 84 eyes of 43 patients treated with diode LPC (group 1) and 58 eyes of 31 patients treated with Nd:YAG LPC (group 2) for ROP in our clinic were enrolled in the study. Medical records of all patients were investigated retrospectively. The patients in each group were examined in terms of birth weights, gestational weeks, stage of retinopathy, number of lasers pots, laser parameters, and anterior and posterior complications of LPC. Results The mean birth weeks of group 1 patients were postmenstrual 27.7 +/- 2.5 (23-33), while the mean birth weights were 1006.0 +/- 334.5 (540-1980) grams. The mean birth weeks of group 2 patients were postmenstrual 27.4 +/- 2.6 (23-33), while the mean birth weights were 1073.8 +/- 329.2 (480-1720) grams. The mean numbers of laser spots were 1036.0 +/- 515.2 (430-2410) in group 1 per eye, while the mean numbers of laser spots were 1085.4 +/- 526.0 (445-2530) in group 2 per eye (p >= 0.05). Additional laser application was performed in four eyes (4.8%) in group 1 and four eyes (6.9%) in group 2. Four eyes (4.8%) treated with diode LPC and one eye (1.7%) treated with Nd:YAG laser developed retinal detachment. Two eyes of a patient (3.4%) applied Nd:YAG LPC developed cataract. Conclusion Cataract may develop when Nd:YAG laser is used; however, posterior segment complications may be more likely to appear with the use of diode laser in these cases.Öğe Crocin attenuates oxidative and inflammatory stress-related periodontitis in cardiac tissues in rats(Wroclaw Medical Univ, 2021) Kocaman, Gulhan; Altinoz, Eyup; Erdemli, Mehmet Erman; Gul, Mehmet; Erdemli, Zeynep; Zayman, Emrah; Bag, Harika Gozde GozukaraBackground. Periodontitis, a chronic inflammatory disease affecting the supporting tissues around the teeth, causes significant inflammatory and oxidative changes in cardiac tissue. Crocin is the active constituent of Crocus sativus (saffron) which has antioxidant properties and is protective against cardiovascular disturbances. Objectives. The present study aimed to investigate the protective effects of crocin on periodontitis-induced oxidative/inflammatory cardiac degeneration in rats in vivo. Materials and methods. Thirty female Sprague Dawley rats were randomly divided into 3 groups: control group, periodontitis group (PD) and periodonditis plus crocin group (PD+Cr). Experimental periodontitis was induced by placing silk ligatures on the maxillary second molar teeth for 30 days. Afterward, crocin (100 mg/kg body weight/day) was administered to the PD+Cr group and saline was administered to the PD group and the control group for 15 days. The subjects were sacrificed on the 45th day. Results. Histological and biochemical analyses demonstrated that inducing periodontitis caused obvious damage to cardiac tissues which was significantly ameliorated by crocin (p < 0.05). Significant improvements in bone resorption parameters (cross-linked C-telopeptide of type I collagen and bone alkaline phosphatase) were also observed in the PD+Cr group (p < 0.05). In addition, crocin caused significant reductions of malondialdehyde levels and total oxidant score while antioxidant levels (glutathione, superoxide dismutase, total antioxidant score, and catalase) were significantly higher in PD+Cr group (p < 0.05). Conclusions. This study reveals that periodontitis may cause oxidative damage in cardiac tissue and crocin improves periodontitis-induced degenerative changes in heart tissue, which is associated with its antioxidant properties.Öğe Effect of Melatonin on Increasing the Effectiveness of Liver Preservation Solution(Aves, 2023) Erdogan, Mehmet Mustafa; Erdemli, Mehmet Erman; Ozhan, Onural; Erdemli, Zeynep; Bag, Harika Gozde Gozukara; Vardi, NigarBackground/Aims: Various tissue preservation solutions are used during the removal of the organ and during transplantation to protect the normal histological and biochemical characteristics of tissue while performing a successful liver transplant. In our study, it was aimed to investigate the effects of intraperitoneal melatonin administration on liver preservation damage before transplantation. Materials and Methods: In our study, the histological and biochemical characteristics of University of Wisconsin + melatonin group rats treated with melatonin 45 minutes before hepatectomy were compared between serum physiologic group and University of Wisconsin group. Results: When hematoxylin and eosin staining was evaluated in terms of hydropic degeneration, sinusoidal dilatation, and hepatocyte necrosis, there was no statistically significant difference. Caspase 3 immunohistochemical staining showed a significant increase in Caspase 3 immunoreactivity positivity at the 12th-hour University of Wisconsin group compared to University of Wisconsin + melatonin group. As a result of biochemical analysis, the malondialdehyde and total oxidant status levels in the University of Wisconsin + melatonin group decreased significantly compared to the University of Wisconsin group. When the reduced glutathione activity and total antioxidant capacity level were compared, a significant increase was observed in the University of Wisconsin + melatonin group compared to the University of Wisconsin group at the 12(th) hour. It was also found that aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase levels decreased significantly in the University of Wisconsin + melatonin 12(th)-hour group compared to the University of Wisconsin 12(th) hour and control group. Conclusion: When the findings were evaluated, intraperitoneal administration of melatonin, a cytoprotective antioxidant, was found to play an effective role in preserving immunohistochemical and biochemical properties of liver tissue integrity and hepatocytes in University of Wisconsin solution.Öğe Effect of Piracetam and Iron Treatment on Heart Rate Variability in Patients With Breath-Holding Spell(Elsevier Science Inc, 2024) Oncul, Mehmet; Elkiran, Ozlem; Karakurt, Cemsit; Gungor, Serdal; Maras, Serdar Akin; Bag, Harika Gozde GozukaraBackground: Breath-holding spells are a benign condition primarily seen in 3% to 5% of healthy children aged between six months and five years. Although no specific treatment is recommended due to its benign nature, iron and piracetam are used in severe or recurrent cases. We planned to compare the heart rate variability (HRV) before and after treatment with 24 -hour Holter monitoring in patients receiving iron and piracetam treatment and investigate the treatment's effectiveness. Methods: Twenty-five patients who applied to the outpatient clinic between 2013 and 2015 due to breath-holding spells were included in the study. The patients who received piracetam and iron therapy and underwent 24 -hour rhythm Holter monitoring were evaluated retrospectively. Results: Fourteen (56%) of these patients were evaluated as having cyanotic-type and 11 (44%) patients were assessed as having pale -type breath-holding spells. A significant difference was found only between hourly peak heart rate and total power in the group receiving iron treatment. Significant differences were also found among the minimum heart rate, mean heart rate, the standard deviation of RR intervals, the mean square root of the sum of the squares of their difference between adjacent RR intervals, spectpow, and low frequency before and after the treatment in the patients who started piracetam treatment ( P < 0.05). Conclusions: Our study is critical as it is the first to investigate the effects of treatment options on various HRV in patients with breath-holding spells. There were statistically significant changes in HRV parameters in patients receiving piracetam, and the number of attacks decreased significantly. Piracetam treatment contributes positively to the breath-holding spell with regard to efficacy and HRV, therefore it can be used to treat breath-holding spells. (c) 2024 Elsevier Inc. All rights reserved.Öğe Effects of noopept on cognitive functions and pubertal process in rats with diabetes(Pergamon-Elsevier Science Ltd, 2019) Gurbuz, Perihan; Duzova, Halil; Yildiz, Azibe; Cakan, Pinar; Kaya, Gul Busra; Bag, Harika Gozde Gozukara; Durhan, MerveAim: Type 1 diabetes (T1DM) is a common chronic disease in childhood. Increasing insulin resistance in puberty gives rise to higher doses of insulin usage in treatment. Of this reason new approaches in treatment are needed. Noopept researches suggest it to have anti-diabetic properties. We tried to determine the effects of noopept on pubertal diabetes. Main method: The research was made with 60 prepubertal, 28 day-old, male, Sprague Dawley rats. The rats were divided into randomised 6 groups (n = 10/group). i) Control, ii) Diabetes Control, iii) Noopept Control, iv) Diabetes + Noopept, v) Diabetes + Insulin, vi) Diabetes + Insulin + Noopept. T1DM model was induced by streptozotocin on postnatal 28th day. 0.5 mg/kg noopept and 1 IU insulin were administered intraperitoneally for 14 days. Blood glucose and body weight measurements, puberty follow-up and MWM tests were performed. Hippocampus, hypothalamus and testis were evaluated histologically. Hypothalamic GnRH and kisspeptin were studied immunohistochemically. Serum LH, FSH and insulin, hippocampal homogenate NGF and BDNF levels were determined by ELISA. Key findings: Delayed puberty was normalized by noopept (p < 0.05). Blood glucose levels were lower in noopept-administered diabetic groups (p < 0.05). Noopept decreased HOMA-IR in insulin administered diabetic group (p < 0.05). Number of degenerated cells in hippocampus and testis were higher in diabetes control group when compared with other groups (p < 0.05). GnRH immunoreactivity in Diabetes + Noopept group was increased when compared to insulin + noopept group (p = 0.018). There was no difference in kisspeptin, serum LH, FSH, hippocampal NGF-BDNF levels and spatial learning assessment among groups (p > 0.05). Significance: Noopept may have positive effect in treatment of pubertal diabetes.Öğe High Carbohydrate, Fat, and Protein Diets Have a Critical Role in Folliculogenesis and Oocyte Development in Rats(Springer Heidelberg, 2024) Gul, Semir; Gul, Mehmet; Otlu, Baris; Erdemli, Mehmet Erman; Bag, Harika Gozde GozukaraTo date, there is no comparative data on the effects of carbohydrates, fat, and proteins, which are macronutrients, on female reproductive functions. Therefore, in this study, we investigated the effects of diets enriched with carbohydrates, fats, and proteins on folliculogenesis and oocyte development in female rats. 21-day-old rats that were just weaned were divided into 4 groups: control, carbohydrate, fat, and protein. The control group was fed with standard chow and the carbohydrate, fat, and protein groups were fed diets enriched with 75% carbohydrate, 60% fat, and 50% protein for 11 weeks, respectively. It was found that high-fat and high-protein diets caused an increase in the estrous cycle length compared to carbohydrate group (p < 0.05). Graafian follicle number decreased in the protein group compared to the control (p < 0.05). However, the atretic follicle number was higher in the fat group compared to the control group (p < 0.05). In the carbohydrate group, Zp1 was found to be lower than the control and protein groups, Zp2 was found to be lower than the control, and Zp3 was found to be lower than the fat group (p < 0.05). While BMP15 was similar between groups (p > 0.05), GDF9 was lower in all diet groups compared to the control (p < 0.05). Foxo3a was lower in the protein group compared to carbohydrate and control (p < 0.05). GAS2 was found to be higher in the control group than the fat group, and higher in the carbohydrate group than the fat and protein groups (p < 0.05). FSH, LH, Progesterone, and E2 levels were higher in all three diet groups than in the control (p < 0.05). Also, significant differences were observed between the groups regarding adiponectin, resistin, and leptin levels. Taken together, high carbohydrate, fat, and protein intake are associated with impairment of the menstrual cycle, depletion of the developing follicle types, and altered expression of folliculogenesis-specific genes and hormones. Therefore, long-term macronutrient diets may result in shortened reproductive periods and reduced fertilization potential in females in the long run.Öğe Impaction of the polylactic membrane or hydrofiber with silver dressings on the interleukin-6, tumor necrosis factor-?, transforming growth factor-?3 levels in the blood and tissues of pediatric patients with burns(Turkish Assoc Trauma Emergency Surgery, 2021) Demircan, Mehmet; Gurunluoglu, Kubilay; Bag, Harika Gozde Gozukara; Kocbiyik, Alper; Gul, Mehmet; Uremis, Nuray; Gul, SemirBACKGROUND: We aimed to evaluate the effects of two different burn dressings, hydrofiber with a silver (HFAg) and polylactic membrane (PLM), on altering the levels of important biomarkers Interleukin-6 (IL-6), Tumor necrosis factor-alpha (TNF-alpha), Transforming growth factor-beta(3) (TGF-beta(3)) in blood and burnt tissue in children with second-degree burns. METHODS: Children between the ages of one to 16 years, with 25-50% second-degree partial-thickness burns of the total body surface area were included in this study. Patients in the PLM group were dressed with PLM in a typical way according to the manual. The HFAg group was dressed with HFAg and a sterile cover. During and at the end of the 21-day treatment, blood and skin tissue samples were taken from the two burn and control groups. IL-6, TNF-alpha, and TGF-beta beta(3) levels were evaluated in blood and tissue samples from all groups, and the results were analyzed statistically. RESULTS: In the PLM group, IL-6 and TNF-alpha levels decreased early days in both serum and tissue samples to reach normal ranges compared with the HFAg group. In the PLM group, TGF-beta(3) levels were elevated than in other groups for two weeks. CONCLUSION: In this study, we found that PLM controls inflammation earlier in both systemic and burn tissue. We also found that PLM increased the level of TGF-beta(3), which may be associated with the prevention of the development of hypertrophic scar in the burn wound, in the blood and burn tissue during this study.Öğe Infection risk after paediatric liver transplantation(Turkish J Pediatrics, 2020) Selimoglu, Mukadder Ayse; Kaya, Samime; Gungor, Sukru; Varol, Fatma Ilknur; Bag, Harika Gozde Gozukara; Yilmaz, SezaiInfections after liver transplantation (LT), despite prophylactic therapy, are still important causes of morbidity and mortality in children. Although underlying disease and immunosuppression along with the complexity of LT procedure are the major predispositions to infections, there still might be under recognised factors predisposing infections in paediatric LT. In this study, we retrospectively analysed the risk factors of bacterial, viral, and fungal infections after LT in a series of 167 children (median =5 yr.). Of all children, 112 (67%) experienced infections: 93 (55.7%) bacterial, 56 (33.5%) viral and 15 (9%) fungal. Multilogistic regression analysis showed that the need of immunosuppressive switch increased total, bacterial, and viral infection risk 5.3, 2.5, and 2.5 times, respectively, (p=0.001, p=0.021, and p=0,019, respectively). Re-LT increased bacterial infection risk 4.2 times (p=0.040). Viral infection risk was 10 times higher in children who had more than two re-laparotomies (p=0,002). Children who had post-LT, cytomegalovirus (CMV) infection had 5.6 times increased risk for fungal infection (p=0.035). In conclusion, infection is still an important morbidity in paediatric LT and is in close relationship with other morbidities such as surgical complications. CMV infection, itself, is an independent risk factor for fungal infection.Öğe Matrix metalloproteinase 9 gene-MMP9-DNA methylation status in Turkish schizophrenia patients(Walter De Gruyter Gmbh, 2023) Karaaslan, Ezgi; Kartalci, Sukru; Bag, Harika Gozde Gozukara; Acar, CerenObjectives: Schizophrenia is a neuropsychiatric disease caused by disorders in brain development due to genetic and environmental factors. The interactions and mechanisms of the two main etiological factors are not fully understood despite neurobiological, clinical and genetic research and more research is needed. In this study, we aimed to investigate the DNA methylation differences in the matrix metalloproteinase 9 gene (MMP9) between schizophrenia and healthy control groups.Methods: Our study investigates DNA methylation patterns in the MMP9 gene in peripheral blood cells of schizophrenia patients. For this purpose, pyrosequencing method was used to analyze DNA methylation status of C-phosphate-G (CpG) regions in the 7th exon of MMP9 in 40 schizophrenia patients and 32 healthy individuals who admitted to our university hospital's psychiatry clinic.Results: In our results, it has been shown that there is a difference between MMP9 gene DNA methylations between healthy individuals and schizophrenia patients. Significant differences were found in the MMP9 gene exon 7 region in CpG 7-3, CpG 7-4, CpG 7-5 positions and mean methylation patterns between these two groups. Conclusions: This study provided evidence that DNA methylation differences may exist between schizophrenia patients and healthy individuals, and emphasized the epigenetic aspect of the disorder.Öğe Modeling Based on Ensemble Learning Methods for Detection of Diagnostic Biomarkers from LncRNA Data in Rats Treated with Cis-Platinum-Induced Hepatotoxicity(Mdpi, 2023) Kucukakcali, Zeynep; Colak, Cemil; Bag, Harika Gozde Gozukara; Cicek, Ipek Balikci; Ozhan, Onural; Yildiz, Azibe; Danis, NefsunBackground: The first aim of this study is to perform bioinformatic analysis of lncRNAs obtained from liver tissue samples from rats treated with cisplatin hepatotoxicity and without pathology. Another aim is to identify possible biomarkers for the diagnosis/early diagnosis of hepatotoxicity by modeling the data obtained from bioinformatics analysis with ensemble learning methods. Methods: In the study, 20 female Sprague-Dawley rats were divided into a control group and a hepatotoxicity group. Liver samples were taken from rats, and transcriptomic and histopathological analyses were performed. The dataset achieved from the transcriptomic analysis was modeled with ensemble learning methods (stacking, bagging, and boosting). Modeling results were evaluated with accuracy (Acc), balanced accuracy (B-Acc), sensitivity (Se), specificity (Sp), positive predictive value (Ppv), negative predictive value (Npv), and F1 score performance metrics. As a result of the modeling, lncRNAs that could be biomarkers were evaluated with variable importance values. Results: According to histopathological and immunohistochemical analyses, a significant increase was observed in the sinusoidal dilatation and Hsp60 immunoreactivity values in the hepatotoxicity group compared to the control group (p < 0.0001). According to the results of the bioinformatics analysis, 589 lncRNAs showed different expressions in the groups. The stacking model had the best classification performance among the applied ensemble learning models. The Acc, B-Acc, Se, Sp, Ppv, Npv, and F1-score values obtained from this model were 90%, 90%, 80%, 100%, 100%, 83.3%, and 88.9%, respectively. lncRNAs with id rna-XR_005492522.1, rna-XR_005492536.1, and rna-XR_005505831.1 with the highest three values according to the variable importance obtained as a result of stacking modeling can be used as predictive biomarker candidates for hepatotoxicity. Conclusions: Among the ensemble algorithms, the stacking technique yielded higher performance results as compared to the bagging and boosting methods on the transcriptomic data. More comprehensive studies can support the possible biomarkers determined due to the research and the decisive results for the diagnosis of drug-induced hepatotoxicity.Öğe Neopterin Levels and Indoleamine 2,3-Dioxygenase Activity as Biomarkers of Immune System Activation and Childhood Allergic Diseases(Korean Soc Laboratory Medicine, 2019) Unuvar, Songul; Erge, Duygu; Kilicarslan, Bilge; Bag, Harika Gozde Gozukara; Catal, Ferhat; Girgin, Gozde; Baydar, TerkenBackground: Although Th2 immune activation is predominant in allergic diseases, neopterinlevels and indoleamine 2,3-dioxygenase (IDO)-1 activity (kynurenine:tryptophan ratio), which reflect Th1 immune activity, increase with interferon-gamma (IFN-gamma) stimulation. We investigated neopterin, tryptophan, and kynurenine levels as biomarkersof the Th1 immune system activation and changes in IDO-1 activityin children with asthma, allergic rhinitis, and atopic dermatitis, as well as the relationship between these biomarkers and the total IgE level, age, and disease severity. Methods: We divided 205 children (80 girls and 125 boys, four months to 17 years old) into four groups: controls, patients with asthma, patients with allergic rhinitis, and patients with atopic dermatitis. Peripheral venous blood samples were collected. Neopterin levels were determined by an enzyme immunoassay. Tryptophan and kynurenine levels were analyzed using HPLC. IDO-1 enzyme activity was calculated using tryptophan and kynurenine levels. IgE levels were measured. The Mann-Whitney U test, Kruskal-Wallis test, and Conover post-hoc method were used for statistical analysis. Results: Neopterin, tryptophan, and kynurenine levels were higher and IgE levels and IDO-1 enzyme activity were lower in patients with asthma and allergic rhinitis than in controls (P<0.05). Patients with atopic dermatitis showed higher neopterin, tryptophan, and kynurenine levels, higher IDO-1 activity, and lower IgE levels thancontrols (P<0.05). Conclusions: The Th1/Th2 balance is disrupted in children with allergic diseases, concomitant with increased Th1-mediated immune response activation and reduced IgEproduction, which is promoted by Th2-type cytokines.Öğe PREDICTION OF COVID-19 SEVERITY IN SARS-COV-2 RNA-POSITIVE PATIENTS BY DIFFERENT ENSEMBLE LEARNING STRATEGIES(Carbone Editore, 2022) Bag, Harika Gozde Gozukara; Kivrak, Mehmet; Guldogan, Emek; Colak, CemilIntroduction: While the coronavirus only persists marginally for 95% of the infected cases, the remaining 5% are in critical or life-threatening conditions. This study aimed to design an intelligent model that predicts the severity level of the disease by modeling the relationships between the COVID-19 infection severity and the various demographic/clinical features of individuals. Materials and methods: A public dataset of a cross-sectional study including the demographic and symptomatological characteristics of 223 COVID-19 patients was used and randomly partitioned into training (75%) and testing (25%) datasets. During training, the class imbalance problem was solved, and the related factors with the COVID-19 severity were selected using the evolutionary method supported by a genetic algorithm. Neural Network (NN), Support Vector Machine (SVM), QUEST algorithms together with confidence weighted voting, voting, and highest confidence wins strategies (HCWS) were constructed, and the predictive power of models was determined by performance metrics. Results: Based on the performance indicators, among the individual models, the NN model outperformed SVM and QUEST algorithms in the training and testing datasets. However, ensemble approaches gave better predictions as compared to individual models according to all the evaluation metrics. Conclusion: The proposed voting ensemble model outperforms other ensemble and individual machine learning approaches for the severity prediction of COVID-19 disease. The proposed ensemble learning model can be integrated into web or mobile applications to classify the severity of COVID-19 for clinical decision support.
