Corona Virus Disease (COVID-19) has spread globally quickly, and has resulted in a large number of causalities and medical resources insufficiency in many countries. Reverse-transcriptase polymerase chain reaction (RT-PCR) testing is adopted as biopsy tool for confirmation of virus infection. However, its accuracy is as low as 60-70%, which is inefficient to uncover the infected. In comparison, the chest CT has been considered as the prior choice in diagnosis and monitoring progress of COVID-19 infection. Although the COVID-19 diagnostic systems based on artificial intelligence have been developed for assisting doctors in diagnosis, the small sample size and the excessive time consumption limit their applications. To this end, this paper proposed a diagnosis prototype system for COVID-19 infection testing. The proposed deep learning model is trained and is tested on 2267 CT sequences from 1357 patients clinically confirmed with COVID-19 and 1235 CT sequences from non-infected people. The main highlights of the prototype system are: (1) no data augmentation is needed to accurately discriminate the COVID-19 from normal controls with the specificity of 0.92 and sensitivity of 0.93; (2) the raw DICOM image is not necessary in testing. Highly compressed image like Jpeg can be used to allow a quick diagnosis; and (3) it discriminates the virus infection within 6 seconds and thus allows an online test with light cost. We also applied our model on 48 asymptomatic patients diagnosed with COVID-19. We found that: (1) the positive rate of RT-PCR assay is 63.5% (687/1082). (2) 45.8% (22/48) of the RT-PCR assay is negative for asymptomatic patients, yet the accuracy of CT scans is 95.8%. The online detection system is available: http://212.64.70.65/covid .
The outbreak of coronavirus disease (COVID-19) has been a nightmare to citizens, hospitals, healthcare practitioners, and the economy in 2020. The overwhelming number of confirmed cases and suspected cases put forward an unprecedented challenge to the hospital’s capacity of management and medical resource distribution. To reduce the possibility of cross-infection and attend a patient according to his severity level, expertly diagnosis and sophisticated medical examinations are often required but hard to fulfil during a pandemic. To facilitate the assessment of a patient’s severity, this paper proposes a multi-modality feature learning and fusion model for end-to-end covid patient severity prediction using the blood test supported electronic medical record (EMR) and chest computerized tomography (CT) scan images. To evaluate a patient’s severity by the co-occurrence of salient clinical features, the High-order Factorization Network (HoFN) is proposed to learn the impact of a set of clinical features without tedious feature engineering. On the other hand, an attention-based deep convolutional neural network (CNN) using pre-trained parameters are used to process the lung CT images. Finally, to achieve cohesion of cross-modality representation, we design a loss function to shift deep features of both-modality into the same feature space which improves the model’s performance and robustness when one modality is absent. Experimental results demonstrate that the proposed multi-modality feature learning and fusion model achieves high performance in an authentic scenario.
Coronavirus Disease 2019 (COVID-19) causes a sudden turnover to bad at some checkpoints and thus needs the intervention of intensive care unit (ICU). This resulted in urgent and large needs of ICUs posed great risks to the medical system. Estimating the mortality of critical in-patients who were not admitted into the ICU will be valuable to optimize the management and assignment of ICU. Retrospective, 733 in-patients diagnosed with COVID-19 at a local hospital (Wuhan, China), as of March 18, 2020. Demographic, clinical and laboratory results were collected and analyzed using machine learning to build a predictive model. Considering the shortage of ICU beds at the beginning of disease emergence, we defined the mortality for those patients who were predicted to be in needing ICU care yet they did not as Missing-ICU (MI)-mortality. To estimate MI-mortality, a prognostic classification model was built to identify the in-patients who may need ICU care. Its predictive accuracy was 0.8288, with an AUC of 0.9119. On our cohort of 733 patients, 25 in-patients who have been predicted by our model that they should need ICU, yet they did not enter ICU due to lack of shorting ICU wards. Our analysis had shown that the MI-mortality is 41%, yet the mortality of ICU is 32%, implying that enough bed of ICU in treating patients in critical conditions.
Corona Virus Disease 2019 (COVID-19) can cause the patients' condition to become serious at some check-point, and thus patients need the intensive care unit (ICU) intervention to survive. The resulted urgent and extensive needs of ICUs posed significant risks to the management of the medical system. Therefore, it is essential to prognostically identify the patient who may be treated in ICU and estimate the length of stay is essential. In this paper, the support vector machine (SVM) with polynomial kernel was used to identify the difference between patients and predict the need for ICU. In predicting the time patients spent in the ICU, we utilized the least absolute shrinkage and selection operator (LASSO) regression model. The variables ranked within the top ten most significant values were chosen and analyzed individually. The model built by machine learning can accurately assess the differences in ICU, ICU admission, length of ICU stay, and MI-mortality in COVID-19 patients toward optimal ICU resource allocation. Our proposed approach can give 1-15 days before they were actually admitted into ICU. We also found that high sensitivity troponin I and hypersensitive C-reactive protein are two critical prognostic factors among the selected factors since they appeared in all prediction tasks with a higher AUC.
COVID-19 causes burdens to the ICU. Evidence-based planning and optimal allocation of the scarce ICU resources is urgently needed but remains unaddressed. This study aims to identify variables and test the accuracy to predict the need for ICU admission, death despite ICU care, and among survivors, length of ICU stay, before patients were admitted to ICU. Retrospective data from 733 in-patients confirmed with COVD-19 in Wuhan, China, as of March 18, 2020. Demographic, clinical and laboratory were collected and analyzed using machine learning to build the predictive models. The built machine learning model can accurately assess ICU admission, length of ICU stay, and mortality in COVID-19 patients toward optimal allocation of ICU resources. The prediction can be done by using the clinical data collected within 1-15 days before the actual ICU admission. Lymphocyte absolute value involved in all prediction tasks with a higher AUC. The online predictive system is freely available to the public (http://212.64.70.65:8000/).