Automated detection of COVID-19 cases using deep neural networks with X-ray images

Machine Learning for Prediction of Survival Outcomes with Immune-Checkpoint Inhibitors in Urothelial Cancer

Simple Summary

Machine learning (ML) is a form of artificial intelligence that could be used to enhance the efficiency of developing accurate prediction models for survival outcomes with cancer medicines, which is critical in informing disease prognosis and care planning. We used data from two recent clinical trials to develop and validate ML‐based clinical prediction models of the overall and progression‐free survival rates in patients with urothelial cancer initiating the immune checkpoint inhibitor (ICI) atezolizumab. We demonstrated that ML can efficiently develop an accurate prediction model of survival, enable an accurate prognostic risk classification, and provide realistic expectations of treatment outcomes in patients undergoing urothelial cancer-initiating ICIs therapy.

Abstract

Machine learning (ML) may enhance the efficiency of developing accurate prediction models for survival, which is critical in informing disease prognosis and care planning. This study aimed to develop an ML prediction model for survival outcomes in patients with urothelial cancer-initiating atezolizumab and to compare model performances when built using an expert-selected (curated) versus an all-in list (uncurated) of variables. Gradient-boosted machine (GBM), random forest, Cox-boosted, and penalised, generalised linear models (GLM) were evaluated for predicting overall survival (OS) and progression-free survival (PFS) outcomes. C-statistic (c) was utilised to evaluate model performance. The atezolizumab cohort in IMvigor210 was used for model training, and IMvigor211 was used for external model validation. The curated list consisted of 23 pretreatment factors, while the all-in list consisted of 75. Using the best-performing model, patients were stratified into risk tertiles. Kaplan–Meier analysis was used to estimate survival probabilities. On external validation, the curated list GBM model provided slightly higher OS discrimination (c = 0.71) than that of the random forest (c = 0.70), CoxBoost (c = 0.70), and GLM (c = 0.69) models. All models were equivalent in predicting PFS (c = 0.62). Expansion to the uncurated list was associated with worse OS discrimination (GBM c = 0.70; random forest c = 0.69; CoxBoost c = 0.69, and GLM c = 0.69). In the atezolizumab IMvigor211 cohort, the curated list GBM model discriminated 1-year OS probabilities for the low-, intermediate-, and high-risk groups at 66%, 40%, and 12%, respectively. The ML model discriminated urothelial-cancer patients with distinctly different survival risks, with the GBM applied to a curated list attaining the highest performance. Expansion to an all-in approach may harm model performance.

DenseCapsNet: Detection of COVID-19 from X-ray images using a capsule neural network

At present, the global pandemic as it relates to novel coronavirus pneumonia is still a very difficult situation. Due to the recent outbreak of novel coronavirus pneumonia, novel chest X-ray (CXR) images that can be used for deep learning analysis are very rare. To solve this problem, we propose a deep learning framework that integrates a convolutional neural network and a capsule network. DenseCapsNet, a new deep learning framework, is formed by the fusion of a dense convolutional network (DenseNet) and the capsule neural network (CapsNet), leveraging their respective advantages and reducing the dependence of convolutional neural networks on a large amount of data. Using 750 CXR images of lungs of healthy patients as well as those of patients with other pneumonia and novel coronavirus pneumonia, the method can obtain an accuracy of 90.7% and an F1 score of 90.9%, and the sensitivity for detecting COVID-19 can reach 96%. These results show that the deep fusion neural network DenseCapsNet has good performance in novel coronavirus pneumonia CXR radiography detection.

CovidXrayNet: Optimizing data augmentation and CNN hyperparameters for improved COVID-19 detection from CXR

To mitigate the spread of the current coronavirus disease 2019 (COVID-19) pandemic, it is crucial to have an effective screening of infected patients to be isolated and treated. Chest X-Ray (CXR) radiological imaging coupled with Artificial Intelligence (AI) applications, in particular Convolutional Neural Network (CNN), can speed the COVID-19 diagnostic process. In this paper, we optimize the data augmentation and the CNN hyperparameters for detecting COVID-19 from CXRs in terms of validation accuracy. This optimization increases the accuracy of the popular CNN architectures such as the Visual Geometry Group network (VGG-19) and the Residual Neural Network (ResNet-50), by 11.93% and 4.97%, respectively. We then proposed CovidXrayNet model that is based on EfficientNet-B0 and our optimization results. We evaluated CovidXrayNet on two datasets, including our generated balanced COVIDcxr dataset (960 CXRs) and the benchmark COVIDx dataset (15,496 CXRs). With only 30 epochs of training, CovidXrayNet achieves state-of-the-art accuracy of 95.82% on the COVIDx dataset in the three-class classification task (COVID-19, normal or pneumonia). The CovidXRayNet model, the COVIDcxr dataset, and several optimization experiments are publicly available at https://github.com/MaramMonshi/CovidXrayNet.

Convolutional neural networks and temporal CNNs for COVID-19 forecasting in France

This paper focus on multiple CNN-based (Convolutional Neural Network) models for COVID-19 forecast developed by our research team during the first French lockdown. In an effort to understand and predict both the epidemic evolution and the impacts of this disease, we conceived models for multiple indicators: daily or cumulative confirmed cases, hospitalizations, hospitalizations with artificial ventilation, recoveries, and deaths. In spite of the limited data available when the lockdown was declared, we achieved good short-term performances at the national level with a classical CNN for hospitalizations, leading to its integration into a hospitalizations surveillance tool after the lockdown ended. Also, A Temporal Convolutional Network with quantile regression successfully predicted multiple COVID-19 indicators at the national level by using data available at different scales (worldwide, national, regional). The accuracy of the regional predictions was improved by using a hierarchical pre-training scheme, and an efficient parallel implementation allows for quick training of multiple regional models. The resulting set of models represent a powerful tool for short-term COVID-19 forecasting at different geographical scales, complementing the toolboxes used by health organizations in France.

A diagnostic genomic signal processing (GSP)-based system for automatic feature analysis and detection of COVID-19

Coronavirus Disease 2019 (COVID-19) is a sudden viral contagion that appeared at the end of last year in Wuhan city, the Chinese province of Hubei, China. The fast spread of COVID-19 has led to a dangerous threat to worldwide health. Also in the last two decades, several viral epidemics have been listed like the severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002/2003, the influenza H1N1 in 2009 and recently the Middle East respiratory syndrome coronavirus (MERS-CoV) which appeared in Saudi Arabia in 2012. In this research, an automated system is created to differentiate between the COVID-19, SARS-CoV and MERS-CoV epidemics by using their genomic sequences recorded in the NCBI GenBank in order to facilitate the diagnosis process and increase the accuracy of disease detection in less time. The selected database contains 76 genes for each epidemic. Then, some features are extracted like a discrete Fourier transform (DFT), discrete cosine transform (DCT) and the seven moment invariants to two different classifiers. These classifiers are the k-nearest neighbor (KNN) algorithm and the trainable cascade-forward back propagation neural network where they give satisfying results to compare. To evaluate the performance of classifiers, there are some effective parameters calculated. They are accuracy (ACC), F1 score, error rate and Matthews correlation coefficient (MCC) that are 100%, 100%, 0 and 1, respectively, for the KNN algorithm and 98.89%, 98.34%, 0.0111 and 0.9754, respectively, for the cascade-forward network.

COVID-19 Detection Empowered with Machine Learning and Deep Learning Techniques: A Systematic Review

COVID-19 has infected 223 countries and caused 2.8 million deaths worldwide (at the time of writing this article), and the death rate is increasing continuously. Early diagnosis of COVID patients is a critical challenge for medical practitioners, governments, organizations, and countries to overcome the rapid spread of the deadly virus in any geographical area. In this situation, the previous epidemic evidence on Machine Learning (ML) and Deep Learning (DL) techniques encouraged the researchers to play a significant role in detecting COVID-19. Similarly, the rising scope of ML/DL methodologies in the medical domain also advocates its significant role in COVID-19 detection. This systematic review presents ML and DL techniques practiced in this era to predict, diagnose, classify, and detect the coronavirus. In this study, the data was retrieved from three prevalent full-text archives, i.e., Science Direct, Web of Science, and PubMed, using the search code strategy on 16 March 2021. Using professional assessment, among 961 articles retrieved by an initial query, only 40 articles focusing on ML/DL-based COVID-19 detection schemes were selected. Findings have been presented as a country-wise distribution of publications, article frequency, various data collection, analyzed datasets, sample sizes, and applied ML/DL techniques. Precisely, this study reveals that ML/DL technique accuracy lay between 80% to 100% when detecting COVID-19. The RT-PCR-based model with Support Vector Machine (SVM) exhibited the lowest accuracy (80%), whereas the X-ray-based model achieved the highest accuracy (99.7%) using a deep convolutional neural network. However, current studies have shown that an anal swab test is super accurate to detect the virus. Moreover, this review addresses the limitations of COVID-19 detection along with the detailed discussion of the prevailing challenges and future research directions, which eventually highlight outstanding issues.

Artificial intelligence in the diagnosis of COVID-19: challenges and perspectives

Artificial intelligence (AI) is being used to aid in various aspects of the COVID-19 crisis, including epidemiology, molecular research and drug development, medical diagnosis and treatment, and socioeconomics. The association of AI and COVID-19 can accelerate to rapidly diagnose positive patients. To learn the dynamics of a pandemic with relevance to AI, we search the literature using the different academic databases (PubMed, PubMed Central, Scopus, Google Scholar) and preprint servers (bioRxiv, medRxiv, arXiv). In the present review, we address the clinical applications of machine learning and deep learning, including clinical characteristics, electronic medical records, medical images (CT, X-ray, ultrasound images, etc.) in the COVID-19 diagnosis. The current challenges and future perspectives provided in this review can be used to direct an ideal deployment of AI technology in a pandemic.

Detection of COVID-19 from CT Lung Scans Using Transfer Learning

This paper aims to investigate the use of transfer learning architectures in the detection of COVID-19 from CT lung scans. The study evaluates the performances of various transfer learning architectures, as well as the effects of the standard Histogram Equalization and Contrast Limited Adaptive Histogram Equalization. The findings of this study suggest that transfer learning-based frameworks are an alternative to the contemporary methods used to detect the presence of the virus in patients. The highest performing model, the VGG-19 implemented with the Contrast Limited Adaptive Histogram Equalization, on a SARS-CoV-2 dataset, achieved an accuracy and recall of 95.75% and 97.13%, respectively.

Medical image analysis based on deep learning approach

Medical imaging plays a significant role in different clinical applications such as medical procedures used for early detection, monitoring, diagnosis, and treatment evaluation of various medical conditions. Basicsof the principles and implementations of artificial neural networks and deep learning are essential for understanding medical image analysis in computer vision. Deep Learning Approach (DLA) in medical image analysis emerges as a fast-growing research field. DLA has been widely used in medical imaging to detect the presence or absence of the disease. This paper presents the development of artificial neural networks, comprehensive analysis of DLA, which delivers promising medical imaging applications. Most of the DLA implementations concentrate on the X-ray images, computerized tomography, mammography images, and digital histopathology images. It provides a systematic review of the articles for classification, detection, and segmentation of medical images based on DLA. This review guides the researchers to think of appropriate changes in medical image analysis based on DLA.

Applying deep learning in digital breast tomosynthesis for automatic breast cancer detection: A review

The relatively recent reintroduction of deep learning has been a revolutionary force in the interpretation of diagnostic imaging studies. However, the technology used to acquire those images is undergoing a revolution itself at the very same time. Digital breast tomosynthesis (DBT) is one such technology, which has transformed the field of breast imaging. DBT, a form of three-dimensional mammography, is rapidly replacing the traditional two-dimensional mammograms. These parallel developments in both the acquisition and interpretation of breast images present a unique case study in how modern AI systems can be designed to adapt to new imaging methods. They also present a unique opportunity for co-development of both technologies that can better improve the validity of results and patient outcomes. In this review, we explore the ways in which deep learning can be best integrated into breast cancer screening workflows using DBT. We first explain the principles behind DBT itself and why it has become the gold standard in breast screening. We then survey the foundations of deep learning methods in diagnostic imaging, and review the current state of research into AI-based DBT interpretation. Finally, we present some of the limitations of integrating AI into clinical practice and the opportunities these present in this burgeoning field.

Framework for Real-Time Detection and Identification of possible patients of COVID-19 at public places

The novel Corona Virus (COVID-19) has become the reason for the world to declare it as a global pandemic, which has already taken many lives from all around the world. This pandemic has become a disaster since the spreading rate from person to person is incredibly high and many techniques have come forth to aid in stopping the infection. Although various types of methods have been put into implementation, the search and suggestions of new approaches to reduce the increasing rate of infection will never come to an end until a vaccine terminates this pandemic. This study focuses on proposing a new framework that is based on Deep Learning algorithms for recognizing the COVID-19 cases, mostly in public places. The algorithms include Background Subtraction for extracting the foreground of thermal images from thermal videos generated by Thermal Cameras through the Thermal Imaging process and the Convolutional Neural Network for detecting people infected with the virus. This automated prototype works in a real-time scenario that helps identify people with the disease and will try to trace it while separating them from having any other contact. This proposal intends to achieve a satisfying growth in determining the real cases of COVID-19 and minimize the spreading rate of this virus to the max, ultimately avoiding more deaths.

COVID-19 infection map generation and detection from chest X-ray images

Computer-aided diagnosis has become a necessity for accurate and immediate coronavirus disease 2019 (COVID-19) detection to aid treatment and prevent the spread of the virus. Numerous studies have proposed to use Deep Learning techniques for COVID-19 diagnosis. However, they have used very limited chest X-ray (CXR) image repositories for evaluation with a small number, a few hundreds, of COVID-19 samples. Moreover, these methods can neither localize nor grade the severity of COVID-19 infection. For this purpose, recent studies proposed to explore the activation maps of deep networks. However, they remain inaccurate for localizing the actual infestation making them unreliable for clinical use. This study proposes a novel method for the joint localization, severity grading, and detection of COVID-19 from CXR images by generating the so-called infection maps. To accomplish this, we have compiled the largest dataset with 119,316 CXR images including 2951 COVID-19 samples, where the annotation of the ground-truth segmentation masks is performed on CXRs by a novel collaborative human–machine approach. Furthermore, we publicly release the first CXR dataset with the ground-truth segmentation masks of the COVID-19 infected regions. A detailed set of experiments show that state-of-the-art segmentation networks can learn to localize COVID-19 infection with an F1-score of 83.20%, which is significantly superior to the activation maps created by the previous methods. Finally, the proposed approach achieved a COVID-19 detection performance with 94.96% sensitivity and 99.88% specificity.

Automated detection of COVID-19 from CT scan using convolutional neural network

Under the prevailing circumstances of the global pandemic of COVID-19, early diagnosis and accurate detection of COVID-19 through tests/screening and, subsequently, isolation of the infected people would be a proactive measure. Artificial intelligence (AI) based solutions, using Convolutional Neural Network (CNN) and exploiting the Deep Learning model's diagnostic capabilities, have been studied in this paper. Transfer Learning approach, based on VGG16 and ResNet50 architectures, has been used to develop an algorithm to detect COVID-19 from CT scan images consisting of Healthy (Normal), COVID-19, and Pneumonia categories. This paper adopts data augmentation and fine-tuning techniques to improve and optimize the VGG16 and ResNet50 model. Further, stratified 5-fold cross-validation has been conducted to test the robustness and effectiveness of the model. The proposed model performs exceptionally well in case of binary classification (COVID-19 vs. Normal) with an average classification accuracy of more than 99% in both VGG16 and ResNet50 based models. In multiclass classification (COVID-19 vs. Normal vs. Pneumonia), the proposed model achieves an average classification accuracy of 86.74% and 88.52% using VGG16 and ResNet50 architectures as baseline, respectively. Experimental results show that the proposed model achieves superior performance and can be used for automated detection of COVID-19 from CT scans.

An Uncertainty-Aware Transfer Learning-Based Framework for COVID-19 Diagnosis

The early and reliable detection of COVID-19 infected patients is essential to prevent and limit its outbreak. The PCR tests for COVID-19 detection are not available in many countries, and also, there are genuine concerns about their reliability and performance. Motivated by these shortcomings, this article proposes a deep uncertainty-aware transfer learning framework for COVID-19 detection using medical images. Four popular convolutional neural networks (CNNs), including VGG16, ResNet50, DenseNet121, and InceptionResNetV2, are first applied to extract deep features from chest X-ray and computed tomography (CT) images. Extracted features are then processed by different machine learning and statistical modeling techniques to identify COVID-19 cases. We also calculate and report the epistemic uncertainty of classification results to identify regions where the trained models are not confident about their decisions (out of distribution problem). Comprehensive simulation results for X-ray and CT image data sets indicate that linear support vector machine and neural network models achieve the best results as measured by accuracy, sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve (AUC). Also, it is found that predictive uncertainty estimates are much higher for CT images compared to X-ray images.

Efficient COVID-19 Segmentation from CT Slices Exploiting Semantic Segmentation with Integrated Attention Mechanism

Coronavirus (COVID-19) is a pandemic, which caused suddenly unexplained pneumonia cases and caused a devastating effect on global public health. Computerized tomography (CT) is one of the most effective tools for COVID-19 screening. Since some specific patterns such as bilateral, peripheral, and basal predominant ground-glass opacity, multifocal patchy consolidation, crazy-paving pattern with a peripheral distribution can be observed in CT images and these patterns have been declared as the findings of COVID-19 infection. For patient monitoring, diagnosis and segmentation of COVID-19, which spreads into the lung, expeditiously and accurately from CT, will provide vital information about the stage of the disease. In this work, we proposed a SegNet-based network using the attention gate (AG) mechanism for the automatic segmentation of COVID-19 regions in CT images. AGs can be easily integrated into standard convolutional neural network (CNN) architectures with a minimum computing load as well as increasing model precision and predictive accuracy. Besides, the success of the proposed network has been evaluated based on dice, Tversky, and focal Tversky loss functions to deal with low sensitivity arising from the small lesions. The experiments were carried out using a fivefold cross-validation technique on a COVID-19 CT segmentation database containing 473 CT images. The obtained sensitivity, specificity, and dice scores were reported as 92.73%, 99.51%, and 89.61%, respectively. The superiority of the proposed method has been highlighted by comparing with the results reported in previous studies and it is thought that it will be an auxiliary tool that accurately detects automatic COVID-19 regions from CT images.

Discovering symptom patterns of COVID-19 patients using association rule mining

BACKGROUND

The COVID-19 pandemic is a significant public health crisis that is hitting hard on people's health, well-being, and freedom of movement, and affecting the global economy. Scientists worldwide are competing to develop therapeutics and vaccines; currently, three drugs and two vaccine candidates have been given emergency authorization use. However, there are still questions of efficacy with regard to specific subgroups of patients and the vaccine's scalability to the general public. Under such circumstances, understanding COVID-19 symptoms is vital in initial triage; it is crucial to distinguish the severity of cases for effective management and treatment. This study aimed to discover symptom patterns and overall symptom rules, including rules disaggregated by age, sex, chronic condition, and mortality status, among COVID-19 patients.

METHODS

This study was a retrospective analysis of COVID-19 patient data made available online by the Wolfram Data Repository through May 27, 2020. We applied a widely used rule-based machine learning technique called association rule mining to identify frequent symptoms and define patterns in the rules discovered.

RESULT

In total, 1,560 patients with COVID-19 were included in the study, with a median age of 52 years. The most frequently occurring symptom was fever (67%), followed by cough (37%), malaise/body soreness (11%), pneumonia (11%), and sore throat (8%). Myocardial infarction, heart failure, and renal disease were present in less than 1% of patients. The top ten significant symptom rules (out of 71 generated) showed cough, septic shock, and respiratory distress syndrome as frequent consequents. If a patient had a breathing problem and sputum production, then, there was higher confidence of that patient having a cough; if cardiac disease, renal disease, or pneumonia was present, then there was a higher confidence of septic shock or respiratory distress syndrome. Symptom rules differed between younger and older patients and between male and female patients. Patients who had chronic conditions or died of COVID-19 had more severe symptom rules than those patients who did not have chronic conditions or survived of COVID-19. Concerning chronic condition rules among 147 patients, if a patient had diabetes, prerenal azotemia, and coronary bypass surgery, there was a certainty of hypertension.

CONCLUSION

The most frequently reported symptoms in patients with COVID-19 were fever, cough, pneumonia, and sore throat; while 1% had severe symptoms, such as septic shock, respiratory distress syndrome, and respiratory failure. Symptom rules differed by age and sex. Patients with chronic disease and patients who died of COVID-19 had severe symptom rules more specifically, cardiovascular-related symptoms accompanied by pneumonia, fever, and cough as consequents.

Information technology solutions, challenges, and suggestions for tackling the COVID-19 pandemic

Various technology innovations and applications have been developed to fight the coronavirus pandemic. The pandemic also has implications for the design, development, and use of technologies. There is an urgent need for a greater understanding of what roles information systems and technology researchers can play in this global pandemic. This paper examines emerging technologies used to mitigate the threats of COVID-19 and relevant challenges related to technology design, development, and use. It also provides insights and suggestions into how information systems and technology scholars can help fight the COVID-19 pandemic. This paper helps promote future research and technology development to produce better solutions for tackling the COVID-19 pandemic and future pandemics.

Hybrid ensemble model for differential diagnosis between COVID-19 and common viral pneumonia by chest X-ray radiograph

BACKGROUND

Chest X-ray radiography (CXR) has been widely considered as an accessible, feasible, and convenient method to evaluate suspected patients' lung involvement during the COVID-19 pandemic. However, with the escalating number of suspected cases, traditional diagnosis via CXR fails to deliver results within a short period of time. Therefore, it is crucial to employ artificial intelligence (AI) to enhance CXRs for obtaining quick and accurate diagnoses. Previous studies have reported the feasibility of utilizing deep learning methods to screen for COVID-19 using CXR and CT results. However, these models only use a single deep learning network for chest radiograph detection; the accuracy of this approach required further improvement.

METHODS

In this study, we propose a three-step hybrid ensemble model, including a feature extractor, a feature selector, and a classifier. First, a pre-trained AlexNet with an improved structure extracts the original image features. Then, the ReliefF algorithm is adopted to sort the extracted features, and a trial-and-error approach is used to select the n most important features to reduce the feature dimension. Finally, an SVM classifier provides classification results based on the n selected features.

RESULTS

Compared to five existing models (InceptionV3: 97.916 ± 0.408%; SqueezeNet: 97.189 ± 0.526%; VGG19: 96.520 ± 1.220%; ResNet50: 97.476 ± 0.513%; ResNet101: 98.241 ± 0.209%), the proposed model demonstrated the best performance in terms of overall accuracy rate (98.642 ± 0.398%). Additionally, compared to the existing models, the proposed model demonstrates a considerable improvement in classification time efficiency (SqueezeNet: 6.602 ± 0.001s; InceptionV3: 12.376 ± 0.002s; ResNet50: 10.952 ± 0.001s; ResNet101: 18.040 ± 0.002s; VGG19: 16.632 ± 0.002s; proposed model: 5.917 ± 0.001s).

CONCLUSION

The model proposed in this article is practical and effective, and can provide high-precision COVID-19 CXR detection. We demonstrated its suitability to aid medical professionals in distinguishing normal CXRs, viral pneumonia CXRs and COVID-19 CXRs efficiently on small sample sizes.

COVIDetection-Net: A tailored COVID-19 detection from chest radiography images using deep learning

In this study, a medical system based on Deep Learning (DL) which we called "COVIDetection-Net" is proposed for automatic detection of new corona virus disease 2019 (COVID-19) infection from chest radiography images (CRIs). The proposed system is based on ShuffleNet and SqueezeNet architecture to extract deep learned features and Multiclass Support Vector Machines (MSVM) for detection and classification. Our dataset contains 1200 CRIs that collected from two different publicly available databases. Extensive experiments were carried out using the proposed model. The highest detection accuracy of 100 % for COVID/NonCOVID, 99.72 % for COVID/Normal/pneumonia and 94.44 % for COVID/Normal/Bacterial pneumonia/Viral pneumonia have been obtained. The proposed system superior all published methods in recall, specificity, precision, F1-Score and accuracy. Confusion Matrix (CM) and Receiver Operation Characteristics (ROC) analysis are also used to depict the performance of the proposed model. Hence the proposed COVIDetection-Net can serve as an efficient system in the current state of COVID-19 pandemic and can be used in everywhere that are facing shortage of test kits.

A Hybrid Model for COVID-19 Monitoring and Prediction

COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has a case-fatality rate of 2–3%, with higher rates among elderly patients and patients with comorbidities. Radiologically, COVID-19 is characterised by multifocal ground-glass opacities, even for patients with mild disease. Clinically, patients with COVID-19 present respiratory symptoms, which are very similar to other respiratory virus infections. Our knowledge regarding the SARS-CoV-2 virus is still very limited. These facts make it vitally important to establish mechanisms that allow to model and predict the evolution of the virus and to analyze the spread of cases under different circumstances. The objective of this article is to present a model developed for the evolution of COVID in the city of Manizales, capital of the Department of Caldas, Colombia, focusing on the methodology used to allow its application to other cases, as well as on the monitoring tools developed for this purpose. This methodology is based on a hybrid model which combines the population dynamics of the SIR model of differential equations with extrapolations based on recurrent neural networks. This combination provides self-explanatory results in terms of a coefficient that fluctuates with the restraint measures, which may be further refined by expert rules that capture the expected changes in such measures.

Application of Machine Learning in Diagnosis of COVID-19 Through X-Ray and CT Images: A Scoping Review

Coronavirus disease, first detected in late 2019 (COVID-19), has spread fast throughout the world, leading to high mortality. This condition can be diagnosed using RT-PCR technique on nasopharyngeal and throat swabs with sensitivity values ranging from 30 to 70%. However, chest CT scans and X-ray images have been reported to have sensitivity values of 98 and 69%, respectively. The application of machine learning methods on CT and X-ray images has facilitated the accurate diagnosis of COVID-19. In this study, we reviewed studies which used machine and deep learning methods on chest X-ray images and CT scans for COVID-19 diagnosis and compared their performance. The accuracy of these methods ranged from 76% to more than 99%, indicating the applicability of machine and deep learning methods in the clinical diagnosis of COVID-19.

Deep learning diagnostic and risk-stratification pattern detection for COVID-19 in digital lung auscultations: clinical protocol for a case-control and prospective cohort study

Background

Lung auscultation is fundamental to the clinical diagnosis of respiratory disease. However, auscultation is a subjective practice and interpretations vary widely between users. The digitization of auscultation acquisition and interpretation is a particularly promising strategy for diagnosing and monitoring infectious diseases such as Coronavirus-19 disease (COVID-19) where automated analyses could help decentralise care and better inform decision-making in telemedicine. This protocol describes the standardised collection of lung auscultations in COVID-19 triage sites and a deep learning approach to diagnostic and prognostic modelling for future incorporation into an intelligent autonomous stethoscope benchmarked against human expert interpretation.

Methods

A total of 1000 consecutive, patients aged ≥ 16 years and meeting COVID-19 testing criteria will be recruited at screening sites and amongst inpatients of the internal medicine department at the Geneva University Hospitals, starting from October 2020. COVID-19 is diagnosed by RT-PCR on a nasopharyngeal swab and COVID-positive patients are followed up until outcome (i.e., discharge, hospitalisation, intubation and/or death). At inclusion, demographic and clinical data are collected, such as age, sex, medical history, and signs and symptoms of the current episode. Additionally, lung auscultation will be recorded with a digital stethoscope at 6 thoracic sites in each patient. A deep learning algorithm (DeepBreath) using a Convolutional Neural Network (CNN) and Support Vector Machine classifier will be trained on these audio recordings to derive an automated prediction of diagnostic (COVID positive vs negative) and risk stratification categories (mild to severe). The performance of this model will be compared to a human prediction baseline on a random subset of lung sounds, where blinded physicians are asked to classify the audios into the same categories.

Discussion

This approach has broad potential to standardise the evaluation of lung auscultation in COVID-19 at various levels of healthcare, especially in the context of decentralised triage and monitoring.

Trial registration: PB_2016-00500, SwissEthics. Registered on 6 April 2020.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12890-021-01467-w.

Deep learning-based improved snapshot ensemble technique for COVID-19 chest X-ray classification

COVID-19 has proven to be a deadly virus, and unfortunately, it triggered a worldwide pandemic. Its detection for further treatment poses a severe threat to researchers, scientists, health professionals, and administrators worldwide. One of the daunting tasks during the pandemic for doctors in radiology is the use of chest X-ray or CT images for COVID-19 diagnosis. Time is required to inspect each report manually. While a CT scan is the better standard, an X-ray is still useful because it is cheaper, faster, and more widely used. To diagnose COVID-19, this paper proposes to use a deep learning-based improved Snapshot Ensemble technique for efficient COVID-19 chest X-ray classification. In addition, the proposed method takes advantage of the transfer learning technique using the ResNet-50 model, which is a pre-trained model. The proposed model uses the publicly accessible COVID-19 chest X-ray dataset consisting of 2905 images, which include COVID-19, viral pneumonia, and normal chest X-ray images. For performance evaluation, the model applied the metrics such as AU-ROC, AU-PR, and Jaccard Index. Furthermore, it also obtained a multi-class micro-average of 97% specificity, 95% f 1-score, and 95% classification accuracy. The obtained results demonstrate that the performance of the proposed method outperformed those of several existing methods. This method appears to be a suitable and efficient approach for COVID-19 chest X-ray classification.

Federated learning for COVID-19 screening from Chest X-ray images

Today, the whole world is facing a great medical disaster that affects the health and lives of the people: the COVID-19 disease, colloquially known as the Corona virus. Deep learning is an effective means to assist radiologists to analyze the vast amount of chest X-ray images, which can potentially have a substantial role in streamlining and accelerating the diagnosis of COVID-19. Such techniques involve large datasets for training and all such data must be centralized in order to be processed. Due to medical data privacy regulations, it is often not possible to collect and share patient data in a centralized data server. In this work, we present a collaborative federated learning framework allowing multiple medical institutions screening COVID-19 from Chest X-ray images using deep learning without sharing patient data. We investigate several key properties and specificities of federated learning setting including the not independent and identically distributed (non-IID) and unbalanced data distributions that naturally arise. We experimentally demonstrate that the proposed federated learning framework provides competitive results to that of models trained by sharing data, considering two different model architectures. These findings would encourage medical institutions to adopt collaborative process and reap benefits of the rich private data in order to rapidly build a powerful model for COVID-19 screening.

Role of Hybrid Deep Neural Networks (HDNNs), Computed Tomography, and Chest X-rays for the Detection of COVID-19

COVID-19 syndrome has extensively escalated worldwide with the induction of the year 2020 and has resulted in the illness of millions of people. COVID-19 patients bear an elevated risk once the symptoms deteriorate. Hence, early recognition of diseased patients can facilitate early intervention and avoid disease succession. This article intends to develop a hybrid deep neural networks (HDNNs), using computed tomography (CT) and X-ray imaging, to predict the risk of the onset of disease in patients suffering from COVID-19. To be precise, the subjects were classified into 3 categories namely normal, Pneumonia, and COVID-19. Initially, the CT and chest X-ray images, denoted as 'hybrid images' (with resolution 1080 × 1080) were collected from different sources, including GitHub, COVID-19 radiography database, Kaggle, COVID-19 image data collection, and Actual Med COVID-19 Chest X-ray Dataset, which are open source and publicly available data repositories. The 80% hybrid images were used to train the hybrid deep neural network model and the remaining 20% were used for the testing purpose. The capability and prediction accuracy of the HDNNs were calculated using the confusion matrix. The hybrid deep neural network showed a 99% classification accuracy on the test set data.

A novel Covid-19 and pneumonia classification method based on F-transform

Nowadays, Covid-19 is the most important disease that affects daily life globally. Therefore, many methods are offered to fight against Covid-19. In this paper, a novel fuzzy tree classification approach was introduced for Covid-19 detection. Since Covid-19 disease is similar to pneumonia, three classes of data sets such as Covid-19, pneumonia, and normal chest x-ray images were employed in this study. A novel machine learning model, which is called the exemplar model, is presented by using this dataset. Firstly, fuzzy tree transformation is applied to each used chest image, and 15 images (3-level F-tree is constructed in this work) are obtained from a chest image. Then exemplar division is applied to these images. A multi-kernel local binary pattern (MKLBP) is applied to each exemplar and image to generate features. Most valuable features are selected using the iterative neighborhood component (INCA) feature selector. INCA selects the most distinctive 616 features, and these features are forwarded to 16 conventional classifiers in five groups. These groups are decision tree (DT), linear discriminant (LD), support vector machine (SVM), ensemble, and k-nearest neighbor (k-NN). The best-resulted classifier is Cubic SVM, and it achieved 97.01% classification accuracy for this dataset.

Deep Learning in the Detection and Diagnosis of COVID-19 Using Radiology Modalities: A Systematic Review

Introduction

The early detection and diagnosis of COVID-19 and the accurate separation of non-COVID-19 cases at the lowest cost and in the early stages of the disease are among the main challenges in the current COVID-19 pandemic. Concerning the novelty of the disease, diagnostic methods based on radiological images suffer from shortcomings despite their many applications in diagnostic centers. Accordingly, medical and computer researchers tend to use machine-learning models to analyze radiology images. Material and Methods. The present systematic review was conducted by searching the three databases of PubMed, Scopus, and Web of Science from November 1, 2019, to July 20, 2020, based on a search strategy. A total of 168 articles were extracted and, by applying the inclusion and exclusion criteria, 37 articles were selected as the research population.

Result

This review study provides an overview of the current state of all models for the detection and diagnosis of COVID-19 through radiology modalities and their processing based on deep learning. According to the findings, deep learning-based models have an extraordinary capacity to offer an accurate and efficient system for the detection and diagnosis of COVID-19, the use of which in the processing of modalities would lead to a significant increase in sensitivity and specificity values.

Conclusion

The application of deep learning in the field of COVID-19 radiologic image processing reduces false-positive and negative errors in the detection and diagnosis of this disease and offers a unique opportunity to provide fast, cheap, and safe diagnostic services to patients.

COVID-19 Infection Detection from Chest X-Ray Images Using Hybrid Social Group Optimization and Support Vector Classifier

A novel strain of Coronavirus, identified as the Severe Acute Respiratory Syndrome-2 (SARS-CoV-2), outbroke in December 2019 causing the novel Corona Virus Disease (COVID-19). Since its emergence, the virus has spread rapidly and has been declared a global pandemic. As of the end of January 2021, there are almost 100 million cases worldwide with over 2 million confirmed deaths. Widespread testing is essential to reduce further spread of the disease, but due to a shortage of testing kits and limited supply, alternative testing methods are being evaluated. Recently researchers have found that chest X-Ray (CXR) images provide salient information about COVID-19. An intelligent system can help the radiologists to detect COVID-19 from these CXR images which can come in handy at remote locations in many developing nations. In this work, we propose a pipeline that uses CXR images to detect COVID-19 infection. The features from the CXR images were extracted and the relevant features were then selected using Hybrid Social Group Optimization algorithm. The selected features were then used to classify the CXR images using a number of classifiers. The proposed pipeline achieves a classification accuracy of 99.65% using support vector classifier, which outperforms other state-of-the-art deep learning algorithms for binary and multi-class classification.

A Vital Sign-based Prediction Algorithm for Differentiating COVID-19 Versus Seasonal Influenza in Hospitalized Patients

Patients with influenza and SARS-CoV2/Coronavirus disease 2019 (COVID-19) infections have different clinical course and outcomes. We developed and validated a supervised machine learning pipeline to distinguish the two viral infections using the available vital signs and demographic dataset from the first hospital/emergency room encounters of 3,883 patients who had confirmed diagnoses of influenza A/B, COVID-19 or negative laboratory test results. The models were able to achieve an area under the receiver operating characteristic curve (ROC AUC) of at least 97% using our multiclass classifier. The predictive models were externally validated on 15,697 encounters in 3,125 patients available on TrinetX database that contains patient-level data from different healthcare organizations. The influenza vs. COVID-19-positive model had an AUC of 98%, and 92% on the internal and external test sets, respectively. Our study illustrates the potentials of machine-learning models for accurately distinguishing the two viral infections. The code is made available at https://github.com/ynaveena/COVID-19-vs-Influenza and may be have utility as a frontline diagnostic tool to aid healthcare workers in triaging patients once the two viral infections start cocirculating in the communities.

Deep Learning-Driven Automated Detection of COVID-19 from Radiography Images: a Comparative Analysis

The COVID-19 pandemic has wreaked havoc on the whole world, taking over half a million lives and capsizing the world economy in unprecedented magnitudes. With the world scampering for a possible vaccine, early detection and containment are the only redress. Existing diagnostic technologies with high accuracy like RT-PCRs are expensive and sophisticated, requiring skilled individuals for specimen collection and screening, resulting in lower outreach. So, methods excluding direct human intervention are much sought after, and artificial intelligence-driven automated diagnosis, especially with radiography images, captured the researchers' interest. This survey marks a detailed inspection of the deep learning-based automated detection of COVID-19 works done to date, a comparison of the available datasets, methodical challenges like imbalanced datasets and others, along with probable solutions with different preprocessing methods, and scopes of future exploration in this arena. We also benchmarked the performance of 315 deep models in diagnosing COVID-19, normal, and pneumonia from X-ray images of a custom dataset created from four others. The dataset is publicly available at https://github.com/rgbnihal2/COVID-19-X-ray-Dataset. Our results show that DenseNet201 model with Quadratic SVM classifier performs the best (accuracy: 98.16%, sensitivity: 98.93%, specificity: 98.77%) and maintains high accuracies in other similar architectures as well. This proves that even though radiography images might not be conclusive for radiologists, but it is so for deep learning algorithms for detecting COVID-19. We hope this extensive review will provide a comprehensive guideline for researchers in this field.

The Effectiveness of Image Augmentation in Deep Learning Networks for Detecting COVID-19: A Geometric Transformation Perspective

Chest X-ray imaging technology used for the early detection and screening of COVID-19 pneumonia is both accessible worldwide and affordable compared to other non-invasive technologies. Additionally, deep learning methods have recently shown remarkable results in detecting COVID-19 on chest X-rays, making it a promising screening technology for COVID-19. Deep learning relies on a large amount of data to avoid overfitting. While overfitting can result in perfect modeling on the original training dataset, on a new testing dataset it can fail to achieve high accuracy. In the image processing field, an image augmentation step (i.e., adding more training data) is often used to reduce overfitting on the training dataset, and improve prediction accuracy on the testing dataset. In this paper, we examined the impact of geometric augmentations as implemented in several recent publications for detecting COVID-19. We compared the performance of 17 deep learning algorithms with and without different geometric augmentations. We empirically examined the influence of augmentation with respect to detection accuracy, dataset diversity, augmentation methodology, and network size. Contrary to expectation, our results show that the removal of recently used geometrical augmentation steps actually improved the Matthews correlation coefficient (MCC) of 17 models. The MCC without augmentation (MCC = 0.51) outperformed four recent geometrical augmentations (MCC = 0.47 for Data Augmentation 1, MCC = 0.44 for Data Augmentation 2, MCC = 0.48 for Data Augmentation 3, and MCC = 0.49 for Data Augmentation 4). When we retrained a recently published deep learning without augmentation on the same dataset, the detection accuracy significantly increased, with aχ McNema r ' s statistic 2 = 163 . 2 and a p-value of 2.23 × 10-37. This is an interesting finding that may improve current deep learning algorithms using geometrical augmentations for detecting COVID-19. We also provide clinical perspectives on geometric augmentation to consider regarding the development of a robust COVID-19 X-ray-based detector.

Systems and Clinical Pharmacology of COVID-19 Therapeutic Candidates: A Clinical and Translational Medicine Perspective

Over 50 million people have been infected with the SARS-CoV-2 virus, while around 1 million have died due to COVID-19 disease progression. COVID-19 presents flu-like symptoms that can escalate, in about 7-10 days from onset, into a cytokine storm causing respiratory failure and death. Although social distancing reduces transmissibility, COVID-19 vaccines and therapeutics are essential to regain socioeconomic normalcy. Even if effective and safe vaccines are found, pharmacological interventions are still needed to limit disease severity and mortality. Integrating current knowledge and drug candidates (approved drugs for repositioning among >35 candidates) undergoing clinical studies (>3000 registered in ClinicalTrials.gov), we employed Systems Pharmacology approaches to project how antivirals and immunoregulatory agents could be optimally evaluated for use. Antivirals are likely to be effective only at the early stage of infection, soon after exposure and before hospitalization, while immunomodulatory agents should be effective in the later-stage cytokine storm. As current antiviral candidates are administered in hospitals over 5-7 days, a long-acting combination that targets multiple SARS-CoV-2 lifecycle steps may provide a long-lasting, single-dose treatment in outpatient settings. Long-acting therapeutics may still be needed even when vaccines become available as vaccines are likely to be approved based on a 50% efficacy target.

Metaheuristic-based Deep COVID-19 Screening Model from Chest X-Ray Images

COVID-19 has affected the whole world drastically. A huge number of people have lost their lives due to this pandemic. Early detection of COVID-19 infection is helpful for treatment and quarantine. Therefore, many researchers have designed a deep learning model for the early diagnosis of COVID-19-infected patients. However, deep learning models suffer from overfitting and hyperparameter-tuning issues. To overcome these issues, in this paper, a metaheuristic-based deep COVID-19 screening model is proposed for X-ray images. The modified AlexNet architecture is used for feature extraction and classification of the input images. Strength Pareto evolutionary algorithm-II (SPEA-II) is used to tune the hyperparameters of modified AlexNet. The proposed model is tested on a four-class (i.e., COVID-19, tuberculosis, pneumonia, or healthy) dataset. Finally, the comparisons are drawn among the existing and the proposed models.

Convolutional neural network model based on radiological images to support COVID-19 diagnosis: Evaluating database biases

As SARS-CoV-2 has spread quickly throughout the world, the scientific community has spent major efforts on better understanding the characteristics of the virus and possible means to prevent, diagnose, and treat COVID-19. A valid approach presented in the literature is to develop an image-based method to support COVID-19 diagnosis using convolutional neural networks (CNN). Because the availability of radiological data is rather limited due to the novelty of COVID-19, several methodologies consider reduced datasets, which may be inadequate, biasing the model. Here, we performed an analysis combining six different databases using chest X-ray images from open datasets to distinguish images of infected patients while differentiating COVID-19 and pneumonia from 'no-findings' images. In addition, the performance of models created from fewer databases, which may imperceptibly overestimate their results, is discussed. Two CNN-based architectures were created to process images of different sizes (512 × 512, 768 × 768, 1024 × 1024, and 1536 × 1536). Our best model achieved a balanced accuracy (BA) of 87.7% in predicting one of the three classes ('no-findings', 'COVID-19', and 'pneumonia') and a specific balanced precision of 97.0% for 'COVID-19' class. We also provided binary classification with a precision of 91.0% for detection of sick patients (i.e., with COVID-19 or pneumonia) and 98.4% for COVID-19 detection (i.e., differentiating from 'no-findings' or 'pneumonia'). Indeed, despite we achieved an unrealistic 97.2% BA performance for one specific case, the proposed methodology of using multiple databases achieved better and less inflated results than from models with specific image datasets for training. Thus, this framework is promising for a low-cost, fast, and noninvasive means to support the diagnosis of COVID-19.

A narrative review on characterization of acute respiratory distress syndrome in COVID-19-infected lungs using artificial intelligence

COVID-19 has infected 77.4 million people worldwide and has caused 1.7 million fatalities as of December 21, 2020. The primary cause of death due to COVID-19 is Acute Respiratory Distress Syndrome (ARDS). According to the World Health Organization (WHO), people who are at least 60 years old or have comorbidities that have primarily been targeted are at the highest risk from SARS-CoV-2. Medical imaging provides a non-invasive, touch-free, and relatively safer alternative tool for diagnosis during the current ongoing pandemic. Artificial intelligence (AI) scientists are developing several intelligent computer-aided diagnosis (CAD) tools in multiple imaging modalities, i.e., lung computed tomography (CT), chest X-rays, and lung ultrasounds. These AI tools assist the pulmonary and critical care clinicians through (a) faster detection of the presence of a virus, (b) classifying pneumonia types, and (c) measuring the severity of viral damage in COVID-19-infected patients. Thus, it is of the utmost importance to fully understand the requirements of for a fast and successful, and timely lung scans analysis. This narrative review first presents the pathological layout of the lungs in the COVID-19 scenario, followed by understanding and then explains the comorbid statistical distributions in the ARDS framework. The novelty of this review is the approach to classifying the AI models as per the by school of thought (SoTs), exhibiting based on segregation of techniques and their characteristics. The study also discusses the identification of AI models and its extension from non-ARDS lungs (pre-COVID-19) to ARDS lungs (post-COVID-19). Furthermore, it also presents AI workflow considerations of for medical imaging modalities in the COVID-19 framework. Finally, clinical AI design considerations will be discussed. We conclude that the design of the current existing AI models can be improved by considering comorbidity as an independent factor. Furthermore, ARDS post-processing clinical systems must involve include (i) the clinical validation and verification of AI-models, (ii) reliability and stability criteria, and (iii) easily adaptable, and (iv) generalization assessments of AI systems for their use in pulmonary, critical care, and radiological settings.

Coronavirus disease (COVID-19) detection in Chest X-Ray images using majority voting based classifier ensemble

Novel coronavirus disease (nCOVID-19) is the most challenging problem for the world. The disease is caused by severe acute respiratory syndrome coronavirus-2 (SARS-COV-2), leading to high morbidity and mortality worldwide. The study reveals that infected patients exhibit distinct radiographic visual characteristics along with fever, dry cough, fatigue, dyspnea, etc. Chest X-Ray (CXR) is one of the important, non-invasive clinical adjuncts that play an essential role in the detection of such visual responses associated with SARS-COV-2 infection. However, the limited availability of expert radiologists to interpret the CXR images and subtle appearance of disease radiographic responses remains the biggest bottlenecks in manual diagnosis. In this study, we present an automatic COVID screening (ACoS) system that uses radiomic texture descriptors extracted from CXR images to identify the normal, suspected, and nCOVID-19 infected patients. The proposed system uses two-phase classification approach (normal vs. abnormal and nCOVID-19 vs. pneumonia) using majority vote based classifier ensemble of five benchmark supervised classification algorithms. The training-testing and validation of the ACoS system are performed using 2088 (696 normal, 696 pneumonia and 696 nCOVID-19) and 258 (86 images of each category) CXR images, respectively. The obtained validation results for phase-I (accuracy (ACC) = 98.062%, area under curve (AUC) = 0.956) and phase-II (ACC = 91.329% and AUC = 0.831) show the promising performance of the proposed system. Further, the Friedman post-hoc multiple comparisons and z-test statistics reveals that the results of ACoS system are statistically significant. Finally, the obtained performance is compared with the existing state-of-the-art methods.

Combining Initial Radiographs and Clinical Variables Improves Deep Learning Prognostication in Patients with COVID-19 from the Emergency Department

PURPOSE

To train a deep learning classification algorithm to predict chest radiograph severity scores and clinical outcomes in patients with coronavirus disease 2019 (COVID-19).

MATERIALS AND METHODS

In this retrospective cohort study, patients aged 21-50 years who presented to the emergency department (ED) of a multicenter urban health system from March 10 to 26, 2020, with COVID-19 confirmation at real-time reverse-transcription polymerase chain reaction screening were identified. The initial chest radiographs, clinical variables, and outcomes, including admission, intubation, and survival, were collected within 30 days (n = 338; median age, 39 years; 210 men). Two fellowship-trained cardiothoracic radiologists examined chest radiographs for opacities and assigned a clinically validated severity score. A deep learning algorithm was trained to predict outcomes on a holdout test set composed of patients with confirmed COVID-19 who presented between March 27 and 29, 2020 (n = 161; median age, 60 years; 98 men) for both younger (age range, 21-50 years; n = 51) and older (age >50 years, n = 110) populations. Bootstrapping was used to compute CIs.

RESULTS

The model trained on the chest radiograph severity score produced the following areas under the receiver operating characteristic curves (AUCs): 0.80 (95% CI: 0.73, 0.88) for the chest radiograph severity score, 0.76 (95% CI: 0.68, 0.84) for admission, 0.66 (95% CI: 0.56, 0.75) for intubation, and 0.59 (95% CI: 0.49, 0.69) for death. The model trained on clinical variables produced an AUC of 0.64 (95% CI: 0.55, 0.73) for intubation and an AUC of 0.59 (95% CI: 0.50, 0.68) for death. Combining chest radiography and clinical variables increased the AUC of intubation and death to 0.88 (95% CI: 0.79, 0.96) and 0.82 (95% CI: 0.72, 0.91), respectively.

CONCLUSION

The combination of imaging and clinical information improves outcome predictions.Supplemental material is available for this article.© RSNA, 2020.

A Radiomics Signature to Quantitatively Analyze COVID-19-Infected Pulmonary Lesions

Assessing pulmonary lesions using computed tomography (CT) images is of great significance to the severity diagnosis and treatment of coronavirus disease 2019 (COVID-19)-infected patients. Such assessment mainly depends on radiologists' subjective judgment, which is inefficient and presents difficulty for those with low levels of experience, especially in rural areas. This work focuses on developing a radiomics signature to quantitatively analyze whether COVID-19-infected pulmonary lesions are mild (Grade I) or moderate/severe (Grade II). We retrospectively analyzed 1160 COVID-19-infected pulmonary lesions from 16 hospitals. First, texture features were extracted from the pulmonary lesion regions of CT images. Then, feature preselection was performed and a radiomics signature was built using a stepwise logistic regression. The stepwise logistic regression also calculated the correlation between the radiomics signature and the grade of a pulmonary lesion. Finally, a logistic regression model was trained to classify the grades of pulmonary lesions. Given a significance level of α = 0.001, the stepwise logistic regression achieved an R (multiple correlation coefficient) of 0.70, which is much larger than Rα = 0.18 (the critical value of R). In the classification, the logistic regression model achieved an AUC of 0.87 on an independent test set. Overall, the radiomics signature is significantly correlated with the grade of a pulmonary lesion in COVID-19 infection. The classification model is interpretable and can assist radiologists in quickly and efficiently diagnosing pulmonary lesions. This work aims to develop a CT-based radiomics signature to quantitatively analyze whether COVID-19-infected pulmonary lesions are mild (Grade I) or moderate/severe (Grade II). The logistic regression model established based on this radiomics signature can assist radiologists to quickly and efficiently diagnose the grades of pulmonary lesions. The model calculates a radiomics score for a lesion and is interpretable and appropriate for clinical use.

Monitoring social distancing under various low light conditions with deep learning and a single motionless time of flight camera

The purpose of this work is to provide an effective social distance monitoring solution in low light environments in a pandemic situation. The raging coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus has brought a global crisis with its deadly spread all over the world. In the absence of an effective treatment and vaccine the efforts to control this pandemic strictly rely on personal preventive actions, e.g., handwashing, face mask usage, environmental cleaning, and most importantly on social distancing which is the only expedient approach to cope with this situation. Low light environments can become a problem in the spread of disease because of people's night gatherings. Especially, in summers when the global temperature is at its peak, the situation can become more critical. Mostly, in cities where people have congested homes and no proper air cross-system is available. So, they find ways to get out of their homes with their families during the night to take fresh air. In such a situation, it is necessary to take effective measures to monitor the safety distance criteria to avoid more positive cases and to control the death toll. In this paper, a deep learning-based solution is proposed for the above-stated problem. The proposed framework utilizes the you only look once v4 (YOLO v4) model for real-time object detection and the social distance measuring approach is introduced with a single motionless time of flight (ToF) camera. The risk factor is indicated based on the calculated distance and safety distance violations are highlighted. Experimental results show that the proposed model exhibits good performance with 97.84% mean average precision (mAP) score and the observed mean absolute error (MAE) between actual and measured social distance values is 1.01 cm.

Triage of potential COVID-19 patients from chest X-ray images using hierarchical convolutional networks

The current COVID-19 pandemic has motivated the researchers to use artificial intelligence techniques for a potential alternative to reverse transcription-polymerase chain reaction due to the limited scale of testing. The chest X-ray (CXR) is one of the alternatives to achieve fast diagnosis, but the unavailability of large-scale annotated data makes the clinical implementation of machine learning-based COVID detection difficult. Another issue is the usage of ImageNet pre-trained networks which does not extract reliable feature representations from medical images. In this paper, we propose the use of hierarchical convolutional network (HCN) architecture to naturally augment the data along with diversified features. The HCN uses the first convolution layer from COVIDNet followed by the convolutional layers from well-known pre-trained networks to extract the features. The use of the convolution layer from COVIDNet ensures the extraction of representations relevant to the CXR modality. We also propose the use of ECOC for encoding multiclass problems to binary classification for improving the recognition performance. Experimental results show that HCN architecture is capable of achieving better results in comparison with the existing studies. The proposed method can accurately triage potential COVID-19 patients through CXR images for sharing the testing load and increasing the testing capacity.

SOM-LWL method for identification of COVID-19 on chest X-rays

The outbreak of coronavirus disease 2019 (COVID-19) has had an immense impact on world health and daily life in many countries. Sturdy observing of the initial site of infection in patients is crucial to gain control in the struggle with COVID-19. The early automated detection of the recent coronavirus disease (COVID-19) will help to limit its dissemination worldwide. Many initial studies have focused on the identification of the genetic material of coronavirus and have a poor detection rate for long-term surgery. The first imaging procedure that played an important role in COVID-19 treatment was the chest X-ray. Radiological imaging is often used as a method that emphasizes the performance of chest X-rays. Recent findings indicate the presence of COVID-19 in patients with irregular findings on chest X-rays. There are many reports on this topic that include machine learning strategies for the identification of COVID-19 using chest X-rays. Other current studies have used non-public datasets and complex artificial intelligence (AI) systems. In our research, we suggested a new COVID-19 identification technique based on the locality-weighted learning and self-organization map (LWL-SOM) strategy for detecting and capturing COVID-19 cases. We first grouped images from chest X-ray datasets based on their similar features in different clusters using the SOM strategy in order to discriminate between the COVID-19 and non-COVID-19 cases. Then, we built our intelligent learning model based on the LWL algorithm to diagnose and detect COVID-19 cases. The proposed SOM-LWL model improved the correlation coefficient performance results between the Covid19, no-finding, and pneumonia cases; pneumonia and no-finding cases; Covid19 and pneumonia cases; and Covid19 and no-finding cases from 0.9613 to 0.9788, 0.6113 to 1 0.8783 to 0.9999, and 0.8894 to 1, respectively. The proposed LWL-SOM had better results for discriminating COVID-19 and non-COVID-19 patients than the current machine learning-based solutions using AI evaluation measures.

XCOVNet: Chest X-ray Image Classification for COVID-19 Early Detection Using Convolutional Neural Networks

COVID-19 (also known as SARS-COV-2) pandemic has spread in the entire world. It is a contagious disease that easily spreads from one person in direct contact to another, classified by experts in five categories: asymptomatic, mild, moderate, severe, and critical. Already more than 66 million people got infected worldwide with more than 22 million active patients as of 5 December 2020 and the rate is accelerating. More than 1.5 million patients (approximately 2.5% of total reported cases) across the world lost their life. In many places, the COVID-19 detection takes place through reverse transcription polymerase chain reaction (RT-PCR) tests which may take longer than 48 h. This is one major reason of its severity and rapid spread. We propose in this paper a two-phase X-ray image classification called XCOVNet for early COVID-19 detection using convolutional neural Networks model. XCOVNet detects COVID-19 infections in chest X-ray patient images in two phases. The first phase pre-processes a dataset of 392 chest X-ray images of which half are COVID-19 positive and half are negative. The second phase trains and tunes the neural network model to achieve a 98.44% accuracy in patient classification.

Non-Adherence Tree Analysis (NATA)-An adherence improvement framework: A COVID-19 case study

Poor medication adherence is a global phenomenon that has received a significant amount of research attention yet remains largely unsolved. Medication non-adherence can blur drug efficacy results in clinical trials, lead to substantial financial losses, increase the risk of relapse and hospitalisation, or lead to death. The most common methods of measuring adherence are post-treatment measures; that is, adherence is usually measured after the treatment has begun. What the authors are proposing in this multidisciplinary study is a new technique for predicting the factors that are likely to cause non-adherence before or during medication treatment, illustrated in the context of potential non-adherence to COVID-19 antiviral medication. Fault Tree Analysis (FTA), allows system analysts to determine how combinations of simple faults of a system can propagate to cause a total system failure. Monte Carlo simulation is a mathematical algorithm that depends heavily on repeated random sampling to predict the behaviour of a system. In this study, the authors propose a new technique called Non-Adherence Tree Analysis (NATA), based on the FTA and Monte Carlo simulation techniques, to improve adherence. Firstly, the non-adherence factors of a medication treatment lifecycle are translated into what is referred to as a Non-Adherence Tree (NAT). Secondly, the NAT is coded into a format that is translated into the GoldSim software for performing dynamic system modelling and analysis using Monte Carlo. Finally, the GoldSim model is simulated and analysed to predict the behaviour of the NAT. NATA is dynamic and able to learn from emerging datasets to improve the accuracy of future predictions. It produces a framework for improving adherence by analysing social and non-social adherence barriers. Novel terminologies and mathematical expressions have been developed and applied to real-world scenarios. The results of the application of NATA using data from six previous studies in relation to antiviral medication demonstrate a predictive model which suggests that the biggest factor that could contribute to non-adherence to a COVID-19 antiviral treatment is a therapy-related factor (the side effects of the medication). This is closely followed by a condition-related factor (asymptomatic nature of the disease) then patient-related factors (forgetfulness and other causes). From the results, it appears that side effects, asymptomatic factors and forgetfulness contribute 32.44%, 22.67% and 18.22% respectively to discontinuation of medication treatment of COVID-19 antiviral medication treatment. With this information, clinicians can implement relevant interventions and measures and allocate resources appropriately to minimise non-adherence.

COVID-19 Detection from Chest X-ray Images Using Feature Fusion and Deep Learning

Currently, COVID-19 is considered to be the most dangerous and deadly disease for the human body caused by the novel coronavirus. In December 2019, the coronavirus spread rapidly around the world, thought to be originated from Wuhan in China and is responsible for a large number of deaths. Earlier detection of the COVID-19 through accurate diagnosis, particularly for the cases with no obvious symptoms, may decrease the patient's death rate. Chest X-ray images are primarily used for the diagnosis of this disease. This research has proposed a machine vision approach to detect COVID-19 from the chest X-ray images. The features extracted by the histogram-oriented gradient (HOG) and convolutional neural network (CNN) from X-ray images were fused to develop the classification model through training by CNN (VGGNet). Modified anisotropic diffusion filtering (MADF) technique was employed for better edge preservation and reduced noise from the images. A watershed segmentation algorithm was used in order to mark the significant fracture region in the input X-ray images. The testing stage considered generalized data for performance evaluation of the model. Cross-validation analysis revealed that a 5-fold strategy could successfully impair the overfitting problem. This proposed feature fusion using the deep learning technique assured a satisfactory performance in terms of identifying COVID-19 compared to the immediate, relevant works with a testing accuracy of 99.49%, specificity of 95.7% and sensitivity of 93.65%. When compared to other classification techniques, such as ANN, KNN, and SVM, the CNN technique used in this study showed better classification performance. K-fold cross-validation demonstrated that the proposed feature fusion technique (98.36%) provided higher accuracy than the individual feature extraction methods, such as HOG (87.34%) or CNN (93.64%).

COVID-19: a new deep learning computer-aided model for classification

Chest X-ray (CXR) imaging is one of the most feasible diagnosis modalities for early detection of the infection of COVID-19 viruses, which is classified as a pandemic according to the World Health Organization (WHO) report in December 2019. COVID-19 is a rapid natural mutual virus that belongs to the coronavirus family. CXR scans are one of the vital tools to early detect COVID-19 to monitor further and control its virus spread. Classification of COVID-19 aims to detect whether a subject is infected or not. In this article, a model is proposed for analyzing and evaluating grayscale CXR images called Chest X-Ray COVID Network (CXRVN) based on three different COVID-19 X-Ray datasets. The proposed CXRVN model is a lightweight architecture that depends on a single fully connected layer representing the essential features and thus reducing the total memory usage and processing time verse pre-trained models and others. The CXRVN adopts two optimizers: mini-batch gradient descent and Adam optimizer, and the model has almost the same performance. Besides, CXRVN accepts CXR images in grayscale that are a perfect image representation for CXR and consume less memory storage and processing time. Hence, CXRVN can analyze the CXR image with high accuracy in a few milliseconds. The consequences of the learning process focus on decision making using a scoring function called SoftMax that leads to high rate true-positive classification. The CXRVN model is trained using three different datasets and compared to the pre-trained models: GoogleNet, ResNet and AlexNet, using the fine-tuning and transfer learning technologies for the evaluation process. To verify the effectiveness of the CXRVN model, it was evaluated in terms of the well-known performance measures such as precision, sensitivity, F1-score and accuracy. The evaluation results based on sensitivity, precision, recall, accuracy, and F1 score demonstrated that, after GAN augmentation, the accuracy reached 96.7% in experiment 2 (Dataset-2) for two classes and 93.07% in experiment-3 (Dataset-3) for three classes, while the average accuracy of the proposed CXRVN model is 94.5%.

Using artificial intelligence techniques for COVID-19 genome analysis

The genome of the novel coronavirus (COVID-19) disease was first sequenced in January 2020, approximately a month after its emergence in Wuhan, capital of Hubei province, China. COVID-19 genome sequencing is critical to understanding the virus behavior, its origin, how fast it mutates, and for the development of drugs/vaccines and effective preventive strategies. This paper investigates the use of artificial intelligence techniques to learn interesting information from COVID-19 genome sequences. Sequential pattern mining (SPM) is first applied on a computer-understandable corpus of COVID-19 genome sequences to see if interesting hidden patterns can be found, which reveal frequent patterns of nucleotide bases and their relationships with each other. Second, sequence prediction models are applied to the corpus to evaluate if nucleotide base(s) can be predicted from previous ones. Third, for mutation analysis in genome sequences, an algorithm is designed to find the locations in the genome sequences where the nucleotide bases are changed and to calculate the mutation rate. Obtained results suggest that SPM and mutation analysis techniques can reveal interesting information and patterns in COVID-19 genome sequences to examine the evolution and variations in COVID-19 strains respectively.

COVID-19 Detection by Optimizing Deep Residual Features with Improved Clustering-Based Golden Ratio Optimizer

The COVID-19 virus is spreading across the world very rapidly. The World Health Organization (WHO) declared it a global pandemic on 11 March 2020. Early detection of this virus is necessary because of the unavailability of any specific drug. The researchers have developed different techniques for COVID-19 detection, but only a few of them have achieved satisfactory results. There are three ways for COVID-19 detection to date, those are real-time reverse transcription-polymerize chain reaction (RT-PCR), Computed Tomography (CT), and X-ray plays. In this work, we have proposed a less expensive computational model for automatic COVID-19 detection from Chest X-ray and CT-scan images. Our paper has a two-fold contribution. Initially, we have extracted deep features from the image dataset and then introduced a completely novel meta-heuristic feature selection approach, named Clustering-based Golden Ratio Optimizer (CGRO). The model has been implemented on three publicly available datasets, namely the COVID CT-dataset, SARS-Cov-2 dataset, and Chest X-Ray dataset, and attained state-of-the-art accuracies of 99.31%, 98.65%, and 99.44%, respectively.

CoVNet-19: A Deep Learning model for the detection and analysis of COVID-19 patients

Background:

The ongoing fight with Novel Corona Virus, getting quick treatment, and rapid diagnosis reports have become an act of high priority. With millions getting infected daily and a fatality rate of 2%, we made it our motive to contribute a little to solve this real-world problem by accomplishing a significant and substantial method for diagnosing COVID-19 patients.

Aim:

The Exponential growth of COVID-19 cases worldwide has severely affected the health care system of highly populated countries due to proportionally a smaller number of medical practitioners, testing kits, and other resources, thus becoming essential to identify the infected people. Catering to the above problems, the purpose of this paper is to formulate an accurate, efficient, and time-saving method for detecting positive corona patients.

Method:

In this paper, an Ensemble Deep Convolution Neural Network model “CoVNet-19” is being proposed that can unveil important diagnostic characteristics to find COVID-19 infected patients using X-ray images chest and help radiologists and medical experts to fight this pandemic.

Results:

The experimental results clearly show that the overall classification accuracy obtained with the proposed approach for three-class classification among COVID-19, Pneumonia, and Normal is 98.28%, along with an average precision and Recall of 98.33% and 98.33%, respectively. Besides this, for binary classification between Non-COVID and COVID Chest X-ray images, an overall accuracy of 99.71% was obtained.

Conclusion:

Having a high diagnostic accuracy, our proposed ensemble Deep Learning classification model can be a productive and substantial contribution to detecting COVID-19 infected patients.

Deep learning models for COVID-19 chest x-ray classification: Preventing shortcut learning using feature disentanglement

In response to the COVID-19 global pandemic, recent research has proposed creating deep learning based models that use chest radiographs (CXRs) in a variety of clinical tasks to help manage the crisis. However, the size of existing datasets of CXRs from COVID-19+ patients are relatively small, and researchers often pool CXR data from multiple sources, for example, using different x-ray machines in various patient populations under different clinical scenarios. Deep learning models trained on such datasets have been shown to overfit to erroneous features instead of learning pulmonary characteristics -- a phenomenon known as shortcut learning. We propose adding feature disentanglement to the training process, forcing the models to identify pulmonary features from the images while penalizing them for learning features that can discriminate between the original datasets that the images come from. We find that models trained in this way indeed have better generalization performance on unseen data; in the best case we found that it improved AUC by 0.13 on held out data. We further find that this outperforms masking out non-lung parts of the CXRs and performing histogram equalization, both of which are recently proposed methods for removing biases in CXR datasets.