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Morís DI, de Moura J, Marcos PJ, Míguez Rey E, Novo J, Ortega M. Efficient clinical decision-making process via AI-based multimodal data fusion: A COVID-19 case study. Heliyon 2024; 10:e38642. [PMID: 39640748 PMCID: PMC11619951 DOI: 10.1016/j.heliyon.2024.e38642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Accepted: 09/26/2024] [Indexed: 12/07/2024] Open
Abstract
COVID-19 is an infectious disease that caused a global pandemic in 2020. In the critical moments of this healthcare emergencies, the medical staff needs to take important decisions in a context of limited resources that must be carefully managed. To this end, the computer-aided diagnosis methods are extremely powerful and help them to better recognize the evidences of high-risk patients. This can be done with the support of relevant information extracted from electronic health records, lab tests and imaging studies. In this work, we present a novel fully-automatic efficient method to help the clinical decision-making process in the context of COVID-19 risk estimation, using multimodal data fusion of clinical features and deep features extracted from chest X-ray images. The risk estimation is studied in two of the most relevant and critical encountered scenarios: the risk of hospitalization and mortality. This study shows which are the most important features for each scenario, the ratio of clinical and imaging features present in the top ranking and the performance of the used machine learning models. The results demonstrate a great performance by the classifiers, estimating the risk of hospitalization with an AUC-ROC of 0.8452 ± 0.0133 and the risk of death with an AUC-ROC of 0.8285 ± 0.0210, only using a subset of the original features, and highlight the significant contribution of imaging features to hospitalization risk assessment, while clinical features become more crucial for mortality risk evaluation. Furthermore, multimodal data fusion can outperform the approaches that use one data source. Despite the model's complexity, it requires fewer features, an advantage in scenarios with limited computational resources. This streamlined, fully-automated method shows promising potential to improve the clinical decision-making process and better manage medical resources, not only in the context of COVID-19, but also in other clinical scenarios.
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Affiliation(s)
- Daniel I. Morís
- Varpa Group, Biomedical Research Institute A Coruña (INIBIC), University of A Coruña, 15006, A Coruña, Spain
- Department of Computer Science and Information Technologies, University of A Coruña, 15071, A Coruña, Spain
| | - Joaquim de Moura
- Varpa Group, Biomedical Research Institute A Coruña (INIBIC), University of A Coruña, 15006, A Coruña, Spain
- Department of Computer Science and Information Technologies, University of A Coruña, 15071, A Coruña, Spain
| | - Pedro J. Marcos
- Dirección Asistencial y Servicio de Neumología, Complejo Hospitalario Universitario de A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, Sergas, 15006 A Coruña, Spain
| | - Enrique Míguez Rey
- Grupo de Investigación en Virología Clínica, Sección de Enfermedades Infecciosas, Servicio de Medicina Interna, Instituto de Investigación Biomédica de A Coruña (INIBIC), Área Sanitaria A Coruña y CEE (ASCC), SERGAS, 15006 A Coruña, Spain
| | - Jorge Novo
- Varpa Group, Biomedical Research Institute A Coruña (INIBIC), University of A Coruña, 15006, A Coruña, Spain
- Department of Computer Science and Information Technologies, University of A Coruña, 15071, A Coruña, Spain
| | - Marcos Ortega
- Varpa Group, Biomedical Research Institute A Coruña (INIBIC), University of A Coruña, 15006, A Coruña, Spain
- Department of Computer Science and Information Technologies, University of A Coruña, 15071, A Coruña, Spain
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3
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Meira DD, Zetum ASS, Casotti MC, Campos da Silva DR, de Araújo BC, Vicente CR, Duque DDA, Campanharo BP, Garcia FM, Campanharo CV, Aguiar CC, Lapa CDA, Alvarenga FDS, Rosa HP, Merigueti LP, Sant’Ana MC, Koh CW, Braga RFR, Cruz RGCD, Salazar RE, Ventorim VDP, Santana GM, Louro TES, Louro LS, Errera FIV, Paula FD, Altoé LSC, Alves LNR, Trabach RSDR, Santos EDVWD, Carvalho EFD, Chan KR, Louro ID. Bioinformatics and molecular biology tools for diagnosis, prevention, treatment and prognosis of COVID-19. Heliyon 2024; 10:e34393. [PMID: 39816364 PMCID: PMC11734128 DOI: 10.1016/j.heliyon.2024.e34393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 04/10/2024] [Accepted: 07/09/2024] [Indexed: 01/18/2025] Open
Abstract
Since December 2019, a new form of Severe Acute Respiratory Syndrome (SARS) has emerged worldwide, caused by SARS coronavirus 2 (SARS-CoV-2). This disease was called COVID-19 and was declared a pandemic by the World Health Organization in March 2020. Symptoms can vary from a common cold to severe pneumonia, hypoxemia, respiratory distress, and death. During this period of world stress, the medical and scientific community were able to acquire information and generate scientific data at unprecedented speed, to better understand the disease and facilitate vaccines and therapeutics development. Notably, bioinformatics tools were instrumental in decoding the viral genome and identifying critical targets for COVID-19 diagnosis and therapeutics. Through the integration of omics data, bioinformatics has also improved our understanding of disease pathogenesis and virus-host interactions, facilitating the development of targeted treatments and vaccines. Furthermore, molecular biology techniques have accelerated the design of sensitive diagnostic tests and the characterization of immune responses, paving the way for precision medicine approaches in treating COVID-19. Our analysis highlights the indispensable contributions of bioinformatics and molecular biology to the global effort against COVID-19. In this review, we aim to revise the COVID-19 features, diagnostic, prevention, treatment options, and how molecular biology, modern bioinformatic tools, and collaborations have helped combat this pandemic. An integrative literature review was performed, searching articles on several sites, including PUBMED and Google Scholar indexed in referenced databases, prioritizing articles from the last 3 years. The lessons learned from this COVID-19 pandemic will place the world in a much better position to respond to future pandemics.
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Affiliation(s)
- Débora Dummer Meira
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Aléxia Stefani Siqueira Zetum
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Matheus Correia Casotti
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Danielle Ribeiro Campos da Silva
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Bruno Cancian de Araújo
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Creuza Rachel Vicente
- Departamento de Medicina Social, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29090-040, Brazil
| | - Daniel de Almeida Duque
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Bianca Paulino Campanharo
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Fernanda Mariano Garcia
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Camilly Victória Campanharo
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Carla Carvalho Aguiar
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Carolina de Aquino Lapa
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Flávio dos Santos Alvarenga
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Henrique Perini Rosa
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Luiza Poppe Merigueti
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Marllon Cindra Sant’Ana
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Clara W.T. Koh
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 169857, Singapore
| | - Raquel Furlani Rocon Braga
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Rahna Gonçalves Coutinho da Cruz
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Rhana Evangelista Salazar
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Vinícius do Prado Ventorim
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Gabriel Mendonça Santana
- Centro de Ciências da Saúde, Curso de Medicina, Universidade Federal do Espírito Santo (UFES), Vitória, Espírito Santo, 29090-040, Brazil
| | - Thomas Erik Santos Louro
- Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória (EMESCAM), Espírito Santo, Vitória, 29027-502, Brazil
| | - Luana Santos Louro
- Centro de Ciências da Saúde, Curso de Medicina, Universidade Federal do Espírito Santo (UFES), Vitória, Espírito Santo, 29090-040, Brazil
| | - Flavia Imbroisi Valle Errera
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Flavia de Paula
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Lorena Souza Castro Altoé
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Lyvia Neves Rebello Alves
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | - Raquel Silva dos Reis Trabach
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
| | | | - Elizeu Fagundes de Carvalho
- Instituto de Biologia Roberto Alcantara Gomes (IBRAG), Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, 20551-030, Brazil
| | - Kuan Rong Chan
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, 169857, Singapore
| | - Iúri Drumond Louro
- Núcleo de Genética Humana e Molecular, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, 29075-910, Brazil
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4
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Singh B, Jevnikar AM, Desjardins E. Artificial Intelligence, Big Data, and Regulation of Immunity: Challenges and Opportunities. Arch Immunol Ther Exp (Warsz) 2024; 72:aite-2024-0006. [PMID: 38421272 DOI: 10.2478/aite-2024-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/30/2024] [Indexed: 03/02/2024]
Abstract
The immune system is regulated by a complex set of genetic, molecular, and cellular interactions. Rapid advances in the study of immunity and its network of interactions have been boosted by a spectrum of "omics" technologies that have generated huge amounts of data that have reached the status of big data (BD). With recent developments in artificial intelligence (AI), theoretical and clinical breakthroughs could emerge. Analyses of large data sets with AI tools will allow the formulation of new testable hypotheses open new research avenues and provide innovative strategies for regulating immunity and treating immunological diseases. This includes diagnosis and identification of rare diseases, prevention and treatment of autoimmune diseases, allergic disorders, infectious diseases, metabolomic disorders, cancer, and organ transplantation. However, ethical and regulatory challenges remain as to how these studies will be used to advance our understanding of basic immunology and how immunity might be regulated in health and disease. This will be particularly important for entities in which the complexity of interactions occurring at the same time and multiple cellular pathways have eluded conventional approaches to understanding and treatment. The analyses of BD by AI are likely to be complicated as both positive and negative outcomes of regulating immunity may have important ethical ramifications that need to be considered. We suggest there is an immediate need to develop guidelines as to how the analyses of immunological BD by AI tools should guide immune-based interventions to treat various diseases, prevent infections, and maintain health within an ethical framework.
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Affiliation(s)
- Bhagirath Singh
- Department of Microbiology and Immunology, University of Western Ontario, London, ON, Canada
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
- Rotman Institute of Philosophy, University of Western Ontario, London, ON, Canada
| | - Anthony M Jevnikar
- Department of Microbiology and Immunology, University of Western Ontario, London, ON, Canada
- Department of Medicine, University of Western Ontario, London, ON, Canada
| | - Eric Desjardins
- Rotman Institute of Philosophy, University of Western Ontario, London, ON, Canada
- Department of Philosophy, University of Western Ontario, London, ON, Canada
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5
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Potamias G, Gkoublia P, Kanterakis A. The two-stage molecular scenery of SARS-CoV-2 infection with implications to disease severity: An in-silico quest. Front Immunol 2023; 14:1251067. [PMID: 38077337 PMCID: PMC10699200 DOI: 10.3389/fimmu.2023.1251067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Introduction The two-stage molecular profile of the progression of SARS-CoV-2 (SCOV2) infection is explored in terms of five key biological/clinical questions: (a) does SCOV2 exhibits a two-stage infection profile? (b) SARS-CoV-1 (SCOV1) vs. SCOV2: do they differ? (c) does and how SCOV2 differs from Influenza/INFL infection? (d) does low viral-load and (e) does COVID-19 early host response relate to the two-stage SCOV2 infection profile? We provide positive answers to the above questions by analyzing the time-series gene-expression profiles of preserved cell-lines infected with SCOV1/2 or, the gene-expression profiles of infected individuals with different viral-loads levels and different host-response phenotypes. Methods Our analytical methodology follows an in-silico quest organized around an elaborate multi-step analysis pipeline including: (a) utilization of fifteen gene-expression datasets from NCBI's gene expression omnibus/GEO repository; (b) thorough designation of SCOV1/2 and INFL progression stages and COVID-19 phenotypes; (c) identification of differentially expressed genes (DEGs) and enriched biological processes and pathways that contrast and differentiate between different infection stages and phenotypes; (d) employment of a graph-based clustering process for the induction of coherent groups of networked genes as the representative core molecular fingerprints that characterize the different SCOV2 progression stages and the different COVID-19 phenotypes. In addition, relying on a sensibly selected set of induced fingerprint genes and following a Machine Learning approach, we devised and assessed the performance of different classifier models for the differentiation of acute respiratory illness/ARI caused by SCOV2 or other infections (diagnostic classifiers), as well as for the prediction of COVID-19 disease severity (prognostic classifiers), with quite encouraging results. Results The central finding of our experiments demonstrates the down-regulation of type-I interferon genes (IFN-1), interferon induced genes (ISGs) and fundamental innate immune and defense biological processes and molecular pathways during the early SCOV2 infection stages, with the inverse to hold during the later ones. It is highlighted that upregulation of these genes and pathways early after infection may prove beneficial in preventing subsequent uncontrolled hyperinflammatory and potentially lethal events. Discussion The basic aim of our study was to utilize in an intuitive, efficient and productive way the most relevant and state-of-the-art bioinformatics methods to reveal the core molecular mechanisms which govern the progression of SCOV2 infection and the different COVID-19 phenotypes.
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Affiliation(s)
- George Potamias
- Computational Biomedicine Laboratory (CBML), Institute of Computer Science, Foundation for Research and Technology-Hellas (FORTH), Heraklion, Greece
| | - Polymnia Gkoublia
- Computational Biomedicine Laboratory (CBML), Institute of Computer Science, Foundation for Research and Technology-Hellas (FORTH), Heraklion, Greece
- Graduate Bioinformatics Program, School of Medicine, University of Crete, Heraklion, Greece
| | - Alexandros Kanterakis
- Computational Biomedicine Laboratory (CBML), Institute of Computer Science, Foundation for Research and Technology-Hellas (FORTH), Heraklion, Greece
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