Role of novel deep-learning-based CT used in management and discharge of COVID-19 patients at a “square cabin” hospital in China (preprint)

ABSTRACT

Background: The chest computed tomography (CT) had been used to define the diagnostic and discharge criteria for COVID-19. However, it is difficult to determine the suitability for discharge of a patient with COVID-19 based on CT features in a clinical setting. Deep learning (DL) technology has demonstrated great success in the medical imaging.Purpose: This study applied the novel deep learning (DL) on chest computed tomography (CT) of COVID-19 patients with consecutive negative respiratory pathogen nucleic acid test results at a “square cabin” hospital in Wuhan, China, with the intent to standardize criteria for discharge.Methods: The study included 270 patients (102men, 168 women; mean age, 51.9 ± 15.6[18–65] years) who had two consecutive negative respiratory pathogen tests (sampling interval ≥1 day) and underwent low-dose CT 1 day after the first negative test, with strict adherence to epidemic prevention standards. The chest CT of COVID-19 patients with negative nucleic acid tests were evalued by DL, and the standard for discharge was a total volume ratio of lesions to lung of less than 50% determined by DL.Results: The average intersection over union is 0.7894. Fifty-seven (21.1%) and 213 (78.9%) patients exhibited normal lung findings and pneumonia, respectively. 54.0% (115/213) involved mild interstitial fibrosis. 18.8% (40/213) had total volume ratio of lesions to lung of more than and equal to 50% according to our severity scale and were monitored continuously in hospital, and three cases of which had a positive follow-up nucleic acid test during hospital observation. None of the 230 discharged cases later tested positive or exhibited pneumonia progression. Conclusions: The novel DL enables the accurate management of COVID-19 patients and can help avoid cluster transmission or exacerbation due to patients with false negitive acid test.