Cardiovascular and Renal Comorbidities Included into Neural Networks Predict the Outcome in COVID-19 Patients Admitted to an Intensive Care Unit: Three-Center, Cross-Validation, Age- and Sex-Matched Study.

Here, we performed a multicenter, age- and sex-matched study to compare the efficiency of various machine learning algorithms in the prediction of COVID-19 fatal outcomes and to develop sensitive, specific, and robust artificial intelligence tools for the prompt triage of patients with severe COVID-19 in the intensive care unit setting. In a challenge against other established machine learning algorithms (decision trees, random forests, extra trees, neural networks, k-nearest neighbors, and gradient boosting: XGBoost, LightGBM, and CatBoost) and multivariate logistic regression as a reference, neural networks demonstrated the highest sensitivity, sufficient specificity, and excellent robustness. Further, neural networks based on coronary artery disease/chronic heart failure, stage 3-5 chronic kidney disease, blood urea nitrogen, and C-reactive protein as the predictors exceeded 90% sensitivity and 80% specificity, reaching AUROC of 0.866 at primary cross-validation and 0.849 at secondary cross-validation on virtual samples generated by the bootstrapping procedure. These results underscore the impact of cardiovascular and renal comorbidities in the context of thrombotic complications characteristic of severe COVID-19. As aforementioned predictors can be obtained from the case histories or are inexpensive to be measured at admission to the intensive care unit, we suggest this predictor composition is useful for the triage of critically ill COVID-19 patients.

Automatic scoring of COVID-19 severity in X-ray imaging based on a novel deep learning workflow.

In this study, we propose a two-stage workflow used for the segmentation and scoring of lung diseases. The workflow inherits quantification, qualification, and visual assessment of lung diseases on X-ray images estimated by radiologists and clinicians. It requires the fulfillment of two core stages devoted to lung and disease segmentation as well as an additional post-processing stage devoted to scoring. The latter integrated block is utilized, mainly, for the estimation of segment scores and computes the overall severity score of a patient. The models of the proposed workflow were trained and tested on four publicly available X-ray datasets of COVID-19 patients and two X-ray datasets of patients with no pulmonary pathology. Based on a combined dataset consisting of 580 COVID-19 patients and 784 patients with no disorders, our best-performing algorithm is based on a combination of DeepLabV3 + , for lung segmentation, and MA-Net, for disease segmentation. The proposed algorithms' mean absolute error (MAE) of 0.30 is significantly reduced in comparison to established COVID-19 algorithms; BS-net and COVID-Net-S, possessing MAEs of 2.52 and 1.83 respectively. Moreover, the proposed two-stage workflow was not only more accurate but also computationally efficient, it was approximately 11 times faster than the mentioned methods. In summary, we proposed an accurate, time-efficient, and versatile approach for segmentation and scoring of lung diseases illustrated for COVID-19 and with broader future applications for pneumonia, tuberculosis, pneumothorax, amongst others.

Indirect supervision applied to COVID-19 and pneumonia classification.

The novel coronavirus 19 (COVID-19) continues to have a devastating effect around the globe, leading many scientists and clinicians to actively seek to develop new techniques to assist with the tackling of this disease. Modern machine learning methods have shown promise in their adoption to assist the healthcare industry through their data and analytics-driven decision making, inspiring researchers to develop new angles to fight the virus. In this paper, we aim to develop a CNN-based method for the detection of COVID-19 by utilizing patients' chest X-ray images. Developing upon the inclusion of convolutional units, the proposed method makes use of indirect supervision based on Grad-CAM. This technique is used in the training process where Grad-CAM's attention heatmaps support the network's predictions. Despite recent progress, scarcity of data has thus far limited the development of a robust solution. We extend upon existing work by combining publicly available data across 5 different sources and carefully annotate the comprising images across three categories: normal, pneumonia, and COVID-19. To achieve a high classification accuracy, we propose a training pipeline based on indirect supervision of traditional classification networks, where the guidance is directed by an external algorithm. With this method, we observed that the widely used, standard networks can achieve an accuracy comparable to tailor-made models, specifically for COVID-19, with one network in particular, VGG-16, outperforming the best of the tailor-made models.