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Al Meslamani AZ, Sobrino I, de la Fuente J. Machine learning in infectious diseases: potential applications and limitations. Ann Med 2024; 56:2362869. [PMID: 38853633 PMCID: PMC11168216 DOI: 10.1080/07853890.2024.2362869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/02/2024] [Indexed: 06/11/2024] Open
Abstract
Infectious diseases are a major threat for human and animal health worldwide. Artificial Intelligence (AI) combined algorithms including Machine Learning and Big Data analytics have emerged as a potential solution to analyse diverse datasets and face challenges posed by infectious diseases. In this commentary we explore the potential applications and limitations of ML to management of infectious disease. It explores challenges in key areas such as outbreak prediction, pathogen identification, drug discovery, and personalized medicine. We propose potential solutions to mitigate these hurdles and applications of ML to identify biomolecules for effective treatment and prevention of infectious diseases. In addition to use of ML for management of infectious diseases, potential applications are based on catastrophic evolution events for the identification of biomolecular targets to reduce risks for infectious diseases and vaccinomics for discovery and characterization of vaccine protective antigens using intelligent Big Data analytics techniques. These considerations set a foundation for developing effective strategies for managing infectious diseases in the future.
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Affiliation(s)
- Ahmad Z. Al Meslamani
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Isidro Sobrino
- SaBio, Instituto de Investigación en Recursos Cinegéticos (IREC), Consejo Superior de Investigaciones Científicas (CSIC), Universidad de Castilla-La Mancha (UCLM)-Junta de Comunidades de Castilla-La Mancha (JCCM), Ciudad Real, Spain
| | - José de la Fuente
- SaBio, Instituto de Investigación en Recursos Cinegéticos (IREC), Consejo Superior de Investigaciones Científicas (CSIC), Universidad de Castilla-La Mancha (UCLM)-Junta de Comunidades de Castilla-La Mancha (JCCM), Ciudad Real, Spain
- Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, OK State University, Stillwater, Oklahoma, USA
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2
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Chen W, Luo H, Li J, Chi J. Long-term trend prediction of pandemic combining the compartmental and deep learning models. Sci Rep 2024; 14:21068. [PMID: 39256475 PMCID: PMC11387753 DOI: 10.1038/s41598-024-72005-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 09/02/2024] [Indexed: 09/12/2024] Open
Abstract
Predicting the spread trends of a pandemic is crucial, but long-term prediction remains challenging due to complex relationships among disease spread stages and preventive policies. To address this issue, we propose a novel approach that utilizes data augmentation techniques, compartmental model features, and disease preventive policies. We also use a breakpoint detection method to divide the disease spread into distinct stages and weight these stages using a self-attention mechanism to account for variations in virus transmission capabilities. Finally, we introduce a long-term spread trend prediction model for infectious diseases based on a bi-directional gated recurrent unit network. To evaluate the effectiveness of our model, we conducted experiments using public datasets, focusing on the prediction of COVID-19 cases in four countries over a period of 210 days. Experiments shown that the Adjust-R2 index of our model exceeds 0.9914, outperforming existing models. Furthermore, our model reduces the mean absolute error by 0.85-4.52% compared to other models. Our combined approach of using both the compartmental and deep learning models provides valuable insights into the dynamics of disease spread.
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Affiliation(s)
- Wanghu Chen
- College of Computer Science and Engineering, Northwest Normal University, Lanzhou, 730070, China.
| | - Heng Luo
- College of Computer Science and Engineering, Northwest Normal University, Lanzhou, 730070, China
| | - Jing Li
- College of Computer Science and Engineering, Northwest Normal University, Lanzhou, 730070, China
| | - Jiacheng Chi
- College of Computer Science and Engineering, Northwest Normal University, Lanzhou, 730070, China
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Baccega D, Castagno P, Fernández Anta A, Sereno M. Enhancing COVID-19 forecasting precision through the integration of compartmental models, machine learning and variants. Sci Rep 2024; 14:19220. [PMID: 39160264 PMCID: PMC11333698 DOI: 10.1038/s41598-024-69660-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 08/07/2024] [Indexed: 08/21/2024] Open
Abstract
Predicting epidemic evolution is essential for making informed decisions and guiding the implementation of necessary countermeasures. Computational models are vital tools that provide insights into illness progression and enable early detection, proactive intervention, and targeted preventive measures. This paper introduces Sybil, a framework that integrates machine learning and variant-aware compartmental models, leveraging a fusion of data-centric and analytic methodologies. To validate and evaluate Sybil's forecasts, we employed COVID-19 data from several European and U.S. states. The dataset included the number of new and recovered cases, fatalities, and variant presence over time. We evaluate the forecasting precision of Sybil in periods in which there is a change in the trend of the pandemic evolution or a new variant appears. Results demonstrate that Sybil outperforms conventional data-centric approaches, being able to forecast accurately the changes in the trend, the magnitude of these changes, and the future prevalence of new variants.
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Affiliation(s)
- Daniele Baccega
- Computer Science Department, Universitá di Torino, Turin, Italy.
- Laboratorio InfoLife, Consorzio Interuniversitario Nazionale per l'Informatica (CINI), Rome, Italy.
| | - Paolo Castagno
- Computer Science Department, Universitá di Torino, Turin, Italy
| | | | - Matteo Sereno
- Computer Science Department, Universitá di Torino, Turin, Italy
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Jiang N, Kolozsvary C, Li Y. Artificial Neural Network Prediction of COVID-19 Daily Infection Count. Bull Math Biol 2024; 86:49. [PMID: 38558267 DOI: 10.1007/s11538-024-01275-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 02/21/2024] [Indexed: 04/04/2024]
Abstract
This study addresses COVID-19 testing as a nonlinear sampling problem, aiming to uncover the dependence of the true infection count in the population on COVID-19 testing metrics such as testing volume and positivity rates. Employing an artificial neural network, we explore the relationship among daily confirmed case counts, testing data, population statistics, and the actual daily case count. The trained artificial neural network undergoes testing in in-sample, out-of-sample, and several hypothetical scenarios. A substantial focus of this paper lies in the estimation of the daily true case count, which serves as the output set of our training process. To achieve this, we implement a regularized backcasting technique that utilize death counts and the infection fatality ratio (IFR), as the death statistics and serological surveys (providing the IFR) as more reliable COVID-19 data sources. Addressing the impact of factors such as age distribution, vaccination, and emerging variants on the IFR time series is a pivotal aspect of our analysis. We expect our study to enhance our understanding of the genuine implications of the COVID-19 pandemic, subsequently benefiting mitigation strategies.
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Affiliation(s)
- Ning Jiang
- Department of Mathematics and Statistics, University of Massachusetts, 710 N Pleasant St, Amherst, 01003, MA, USA
| | - Charles Kolozsvary
- Department of Mathematics and Statistics, University of Massachusetts, 710 N Pleasant St, Amherst, 01003, MA, USA
| | - Yao Li
- Department of Mathematics and Statistics, University of Massachusetts, 710 N Pleasant St, Amherst, 01003, MA, USA.
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Del Pilar Villamil M, Velasco N, Barrera D, Segura-Tinoco A, Bernal O, Hernández JT. Analytical reference framework to analyze non-COVID-19 events. Popul Health Metr 2023; 21:16. [PMID: 37865751 PMCID: PMC10590025 DOI: 10.1186/s12963-023-00316-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 10/05/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has disrupted the healthcare system, leading to delays in detection of other non-COVID-19 diseases. This paper presents ANE Framework (Analytics for Non-COVID-19 Events), a reliable and user-friendly analytical forecasting framework designed to predict the number of patients with non-COVID-19 diseases. Prior to 2020, there were analytical models focused on specific illnesses and contexts. Then, most models have focused on understanding COVID-19 behavior. There is a lack of analytical frameworks that enable disease forecasting for non-COVID-19 diseases. METHODS The ANE Framework utilizes time series analysis to generate forecasting models. The framework leverages daily data from official government sources and employs SARIMA models to forecast the number of non-COVID-19 cases, such as tuberculosis and suicide attempts. RESULTS The framework was tested on five different non-COVID-19 events. The framework performs well across all events, including tuberculosis and suicide attempts, with a Mean Absolute Percentage Error (MAPE) of up to 20% and the consistency remains independent of the behavior of each event. Moreover, a pairwise comparison of averages can lead to over or underestimation of the impact. The disruption caused by the pandemic resulted in a 17% gap (2383 cases) between expected and reported tuberculosis cases, and a 19% gap (2464 cases) for suicide attempts. These gaps varied between 20 and 64% across different cities and regions. The ANE Framework has proven to be reliable for analyzing several diseases and exhibits the flexibility to incorporate new data from various sources. Regular updates and the inclusion of new associated data enhance the framework's effectiveness. CONCLUSIONS Current pandemic shows the necessity of developing flexible models to be adapted to different illness data. The framework developed proved to be reliable for the different diseases analyzed, presenting enough flexibility to update with new data or even include new data from different databases. To keep updated on the result of the project allows the inclusion of new data associated with it. Similarly, the proposed strategy in the ANE framework allows for improving the quality of the obtained results with news events.
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Affiliation(s)
| | - Nubia Velasco
- School of Management, Universidad de los Andes, Bogotá, Colombia
| | - David Barrera
- Departamento de Ingeniería Industrial, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Oscar Bernal
- School of Government, Universidad de los Andes, Bogotá, Colombia
| | - José Tiberio Hernández
- Department of Systems and Computing Engineering, Universidad de Los Andes, Bogotá, Colombia
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Guo Z, Xiao G, Wang Y, Li S, Du J, Dai B, Gong L, Xiao D. Dynamic model of respiratory infectious disease transmission in urban public transportation systems. Heliyon 2023; 9:e14500. [PMID: 36967891 PMCID: PMC10034446 DOI: 10.1016/j.heliyon.2023.e14500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 03/13/2023] Open
Abstract
During the epidemics of respiratory infectious diseases, the use of public transportation increases the risk of disease transmission. Therefore, we established a dynamic model to provide an in-depth understanding of the mechanism of epidemic spread via this route. We designed a computer program to model a rail transit system including four transit lines in a small town in which assumed 70% of the residents commute via these trams in weekdays and the remaining residents take the tram at random. The model could identify the best travel route for each passenger and the specific passengers onboard when the tram passed through each station, and simulate the dynamic spread of a respiratory pathogen as the passengers used the rail transit system. Based on the program operating, we estimated that all residents in the town were ultimately infected, including 86.6% who were infected due to the public transportation system. The remaining individuals were infected at home. As the infection rate increased, the number of infected individuals increased more rapidly. Reducing the frequency of trams, driving private cars or riding bicycles, showing nucleic acid certificates and wearing masks for passengers, etc., are effective measures for the prevention of the spread of epidemic diseases.
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Affiliation(s)
- Zuiyuan Guo
- Department of Infectious Disease Prevention and Control, PLA Northern Theater Command Center for Disease Control and Prevention, Shenyang, China
| | - Guangquan Xiao
- Department of Infectious Disease Prevention and Control, PLA Northern Theater Command Center for Disease Control and Prevention, Shenyang, China
| | - Yayu Wang
- Department of Infectious Disease Prevention and Control, PLA Northern Theater Command Center for Disease Control and Prevention, Shenyang, China
| | - Sidong Li
- Department of Infectious Disease Prevention and Control, PLA Northern Theater Command Center for Disease Control and Prevention, Shenyang, China
| | - Jianhong Du
- Training Base of Non-Commissioned Officer Specialized in Aviation Support of Naval Aeronautical University, Qingdao, China
| | - Botao Dai
- Liaoning Agricultural Development Service Center, Shenyang, China
| | - Lili Gong
- Department of Psychiatry, General Hospital of Northern Theater Command, Shenyang, China
| | - Dan Xiao
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China
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Du H, Dong E, Badr HS, Petrone ME, Grubaugh ND, Gardner LM. Incorporating variant frequencies data into short-term forecasting for COVID-19 cases and deaths in the USA: a deep learning approach. EBioMedicine 2023; 89:104482. [PMID: 36821889 PMCID: PMC9943054 DOI: 10.1016/j.ebiom.2023.104482] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Since the US reported its first COVID-19 case on January 21, 2020, the science community has been applying various techniques to forecast incident cases and deaths. To date, providing an accurate and robust forecast at a high spatial resolution has proved challenging, even in the short term. METHOD Here we present a novel multi-stage deep learning model to forecast the number of COVID-19 cases and deaths for each US state at a weekly level for a forecast horizon of 1-4 weeks. The model is heavily data driven, and relies on epidemiological, mobility, survey, climate, demographic, and SARS-CoV-2 variant frequencies data. We implement a rigorous and robust evaluation of our model-specifically we report on weekly performance over a one-year period based on multiple error metrics, and explicitly assess how our model performance varies over space, chronological time, and different outbreak phases. FINDINGS The proposed model is shown to consistently outperform the CDC ensemble model for all evaluation metrics in multiple spatiotemporal settings, especially for the longer-term (3 and 4 weeks ahead) forecast horizon. Our case study also highlights the potential value of variant frequencies data for use in short-term forecasting to identify forthcoming surges driven by new variants. INTERPRETATION Based on our findings, the proposed forecasting framework improves upon the available state-of-the-art forecasting tools currently used to support public health decision making with respect to COVID-19 risk. FUNDING This work was funded the NSF Rapid Response Research (RAPID) grant Award ID 2108526 and the CDC Contract #75D30120C09570.
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Affiliation(s)
- Hongru Du
- Center for Systems Science and Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA; Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Ensheng Dong
- Center for Systems Science and Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA; Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Hamada S Badr
- Center for Systems Science and Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA; Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA; Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Mary E Petrone
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Nathan D Grubaugh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA; Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, 06510, USA
| | - Lauren M Gardner
- Center for Systems Science and Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA; Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
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Garcia-Vicuña D, López-Cheda A, Jácome MA, Mallor F. Estimation of patient flow in hospitals using up-to-date data. Application to bed demand prediction during pandemic waves. PLoS One 2023; 18:e0282331. [PMID: 36848360 PMCID: PMC9970104 DOI: 10.1371/journal.pone.0282331] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/13/2023] [Indexed: 03/01/2023] Open
Abstract
Hospital bed demand forecast is a first-order concern for public health action to avoid healthcare systems to be overwhelmed. Predictions are usually performed by estimating patients flow, that is, lengths of stay and branching probabilities. In most approaches in the literature, estimations rely on not updated published information or historical data. This may lead to unreliable estimates and biased forecasts during new or non-stationary situations. In this paper, we introduce a flexible adaptive procedure using only near-real-time information. Such method requires handling censored information from patients still in hospital. This approach allows the efficient estimation of the distributions of lengths of stay and probabilities used to represent the patient pathways. This is very relevant at the first stages of a pandemic, when there is much uncertainty and too few patients have completely observed pathways. Furthermore, the performance of the proposed method is assessed in an extensive simulation study in which the patient flow in a hospital during a pandemic wave is modelled. We further discuss the advantages and limitations of the method, as well as potential extensions.
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Affiliation(s)
| | - Ana López-Cheda
- Departamento de Matemáticas, Research Group MODES, CITIC, Universidade da Coruña, A Coruña, Spain
| | - María Amalia Jácome
- Departamento de Matemáticas, Research Group MODES, CITIC, Universidade da Coruña, A Coruña, Spain
| | - Fermin Mallor
- Institute of Smart Cities, Public University of Navawordpadrre, Pamplona, Spain
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Wortel MT, Agashe D, Bailey SF, Bank C, Bisschop K, Blankers T, Cairns J, Colizzi ES, Cusseddu D, Desai MM, van Dijk B, Egas M, Ellers J, Groot AT, Heckel DG, Johnson ML, Kraaijeveld K, Krug J, Laan L, Lässig M, Lind PA, Meijer J, Noble LM, Okasha S, Rainey PB, Rozen DE, Shitut S, Tans SJ, Tenaillon O, Teotónio H, de Visser JAGM, Visser ME, Vroomans RMA, Werner GDA, Wertheim B, Pennings PS. Towards evolutionary predictions: Current promises and challenges. Evol Appl 2023; 16:3-21. [PMID: 36699126 PMCID: PMC9850016 DOI: 10.1111/eva.13513] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022] Open
Abstract
Evolution has traditionally been a historical and descriptive science, and predicting future evolutionary processes has long been considered impossible. However, evolutionary predictions are increasingly being developed and used in medicine, agriculture, biotechnology and conservation biology. Evolutionary predictions may be used for different purposes, such as to prepare for the future, to try and change the course of evolution or to determine how well we understand evolutionary processes. Similarly, the exact aspect of the evolved population that we want to predict may also differ. For example, we could try to predict which genotype will dominate, the fitness of the population or the extinction probability of a population. In addition, there are many uses of evolutionary predictions that may not always be recognized as such. The main goal of this review is to increase awareness of methods and data in different research fields by showing the breadth of situations in which evolutionary predictions are made. We describe how diverse evolutionary predictions share a common structure described by the predictive scope, time scale and precision. Then, by using examples ranging from SARS-CoV2 and influenza to CRISPR-based gene drives and sustainable product formation in biotechnology, we discuss the methods for predicting evolution, the factors that affect predictability and how predictions can be used to prevent evolution in undesirable directions or to promote beneficial evolution (i.e. evolutionary control). We hope that this review will stimulate collaboration between fields by establishing a common language for evolutionary predictions.
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Affiliation(s)
- Meike T. Wortel
- Swammerdam Institute for Life SciencesUniversity of AmsterdamAmsterdamThe Netherlands
| | - Deepa Agashe
- National Centre for Biological SciencesBangaloreIndia
| | | | - Claudia Bank
- Institute of Ecology and EvolutionUniversity of BernBernSwitzerland
- Swiss Institute of BioinformaticsLausanneSwitzerland
- Gulbenkian Science InstituteOeirasPortugal
| | - Karen Bisschop
- Institute for Biodiversity and Ecosystem DynamicsUniversity of AmsterdamAmsterdamThe Netherlands
- Origins CenterGroningenThe Netherlands
- Laboratory of Aquatic Biology, KU Leuven KulakKortrijkBelgium
| | - Thomas Blankers
- Institute for Biodiversity and Ecosystem DynamicsUniversity of AmsterdamAmsterdamThe Netherlands
- Origins CenterGroningenThe Netherlands
| | | | - Enrico Sandro Colizzi
- Origins CenterGroningenThe Netherlands
- Mathematical InstituteLeiden UniversityLeidenThe Netherlands
| | | | | | - Bram van Dijk
- Max Planck Institute for Evolutionary BiologyPlönGermany
| | - Martijn Egas
- Institute for Biodiversity and Ecosystem DynamicsUniversity of AmsterdamAmsterdamThe Netherlands
| | - Jacintha Ellers
- Department of Ecological ScienceVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Astrid T. Groot
- Institute for Biodiversity and Ecosystem DynamicsUniversity of AmsterdamAmsterdamThe Netherlands
| | | | | | - Ken Kraaijeveld
- Leiden Centre for Applied BioscienceUniversity of Applied Sciences LeidenLeidenThe Netherlands
| | - Joachim Krug
- Institute for Biological PhysicsUniversity of CologneCologneGermany
| | - Liedewij Laan
- Department of Bionanoscience, Kavli Institute of NanoscienceTU DelftDelftThe Netherlands
| | - Michael Lässig
- Institute for Biological PhysicsUniversity of CologneCologneGermany
| | - Peter A. Lind
- Department Molecular BiologyUmeå UniversityUmeåSweden
| | - Jeroen Meijer
- Theoretical Biology and Bioinformatics, Department of BiologyUtrecht UniversityUtrechtThe Netherlands
| | - Luke M. Noble
- Institute de Biologie, École Normale Supérieure, CNRS, InsermParisFrance
| | | | - Paul B. Rainey
- Department of Microbial Population BiologyMax Planck Institute for Evolutionary BiologyPlönGermany
- Laboratoire Biophysique et Évolution, CBI, ESPCI Paris, Université PSL, CNRSParisFrance
| | - Daniel E. Rozen
- Institute of Biology, Leiden UniversityLeidenThe Netherlands
| | - Shraddha Shitut
- Origins CenterGroningenThe Netherlands
- Institute of Biology, Leiden UniversityLeidenThe Netherlands
| | | | | | | | | | - Marcel E. Visser
- Department of Animal EcologyNetherlands Institute of Ecology (NIOO‐KNAW)WageningenThe Netherlands
| | - Renske M. A. Vroomans
- Origins CenterGroningenThe Netherlands
- Informatics InstituteUniversity of AmsterdamAmsterdamThe Netherlands
| | | | - Bregje Wertheim
- Groningen Institute for Evolutionary Life SciencesUniversity of GroningenGroningenThe Netherlands
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Benavides EM, Ordobás Gavín M, Mallaina García R, de Miguel García S, Ortíz Pinto M, Doménech Gimenez R, Gandarillas Grande A. COVID-19 dynamics in Madrid (Spain): A new convolutional model to find out the missing information during the first three waves. PLoS One 2022; 17:e0279080. [PMID: 36548226 PMCID: PMC9778560 DOI: 10.1371/journal.pone.0279080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
This article presents a novel mathematical model to describe the spread of an infectious disease in the presence of social and health events: it uses 15 compartments, 7 convolution integrals and 4 types of infected individuals, asymptomatic, mild, moderate and severe. A unique feature of this work is that the convolutions and the compartments have been selected to maximize the number of independent input parameters, leading to a 56-parameter model where only one had to evolve over time. The results show that 1) the proposed mathematical model is flexible and robust enough to describe the complex dynamic of the pandemic during the first three waves of the COVID-19 spread in the region of Madrid (Spain) and 2) the proposed model allows us to calculate the number of asymptomatic individuals and the number of persons who presented antibodies during the first waves. The study shows that the following results are compatible with the reported data: close to 28% of the infected individuals were asymptomatic during the three waves, close to 29% of asymptomatic individuals were detected during the subsequent waves and close to 26% of the Madrid population had antibodies at the end of the third wave. This calculated number of persons with antibodies is in great agreement with four direct measurements obtained from an independent sero-epidemiological research. In addition, six calculated curves (total number of confirmed cases, asymptomatic who are confirmed as positive, hospital admissions and discharges and intensive care units admissions) show good agreement with data from an epidemiological surveillance database.
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Affiliation(s)
- Efrén M. Benavides
- Department of Fluid Mechanics and Aersospace Propulsion, Universidad Politécnica de Madrid, Madrid, Spain
- * E-mail:
| | - María Ordobás Gavín
- Epidemiology Department, Directorate General of Public Health, Madrid Regional Health Authority, Madrid, Spain
| | - Raúl Mallaina García
- Strategic Planning Department, Directorate of Integrated Healthcare Process, Foundation on Innovation and Research in Primary Care Foundation FIIBAP, Madrid, Spain
| | - Sara de Miguel García
- Epidemiology Department, Directorate General of Public Health, Madrid Regional Health Authority, Madrid, Spain
| | - Maira Ortíz Pinto
- Epidemiology Department, Directorate General of Public Health, Madrid Regional Health Authority, Madrid, Spain
| | - Ramón Doménech Gimenez
- Epidemiology Department, Directorate General of Public Health, Madrid Regional Health Authority, Madrid, Spain
| | - Ana Gandarillas Grande
- Epidemiology Department, Directorate General of Public Health, Madrid Regional Health Authority, Madrid, Spain
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Botz J, Wang D, Lambert N, Wagner N, Génin M, Thommes E, Madan S, Coudeville L, Fröhlich H. Modeling approaches for early warning and monitoring of pandemic situations as well as decision support. Front Public Health 2022; 10:994949. [PMID: 36452960 PMCID: PMC9702983 DOI: 10.3389/fpubh.2022.994949] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/21/2022] [Indexed: 11/15/2022] Open
Abstract
The COVID-19 pandemic has highlighted the lack of preparedness of many healthcare systems against pandemic situations. In response, many population-level computational modeling approaches have been proposed for predicting outbreaks, spatiotemporally forecasting disease spread, and assessing as well as predicting the effectiveness of (non-) pharmaceutical interventions. However, in several countries, these modeling efforts have only limited impact on governmental decision-making so far. In light of this situation, the review aims to provide a critical review of existing modeling approaches and to discuss the potential for future developments.
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Affiliation(s)
- Jonas Botz
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany
| | - Danqi Wang
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany
- Bonn-Aachen International Center for Information Technology (B-IT), University of Bonn, Bonn, Germany
| | | | | | | | | | - Sumit Madan
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany
- Department of Computer Science, University of Bonn, Bonn, Germany
| | | | - Holger Fröhlich
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany
- Bonn-Aachen International Center for Information Technology (B-IT), University of Bonn, Bonn, Germany
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12
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Kamalov F, Rajab K, Cherukuri AK, Elnagar A, Safaraliev M. Deep learning for Covid-19 forecasting: State-of-the-art review. Neurocomputing 2022; 511:142-154. [PMID: 36097509 PMCID: PMC9454152 DOI: 10.1016/j.neucom.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/03/2022] [Accepted: 09/04/2022] [Indexed: 11/21/2022]
Abstract
The Covid-19 pandemic has galvanized scientists to apply machine learning methods to help combat the crisis. Despite the significant amount of research there exists no comprehensive survey devoted specifically to examining deep learning methods for Covid-19 forecasting. In this paper, we fill the gap in the literature by reviewing and analyzing the current studies that use deep learning for Covid-19 forecasting. In our review, all published papers and preprints, discoverable through Google Scholar, for the period from Apr 1, 2020 to Feb 20, 2022 which describe deep learning approaches to forecasting Covid-19 were considered. Our search identified 152 studies, of which 53 passed the initial quality screening and were included in our survey. We propose a model-based taxonomy to categorize the literature. We describe each model and highlight its performance. Finally, the deficiencies of the existing approaches are identified and the necessary improvements for future research are elucidated. The study provides a gateway for researchers who are interested in forecasting Covid-19 using deep learning.
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13
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An ensemble n-sub-epidemic modeling framework for short-term forecasting epidemic trajectories: Application to the COVID-19 pandemic in the USA. PLoS Comput Biol 2022; 18:e1010602. [PMID: 36201534 PMCID: PMC9578588 DOI: 10.1371/journal.pcbi.1010602] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 10/18/2022] [Accepted: 09/26/2022] [Indexed: 11/19/2022] Open
Abstract
We analyze an ensemble of n-sub-epidemic modeling for forecasting the trajectory of epidemics and pandemics. These ensemble modeling approaches, and models that integrate sub-epidemics to capture complex temporal dynamics, have demonstrated powerful forecasting capability. This modeling framework can characterize complex epidemic patterns, including plateaus, epidemic resurgences, and epidemic waves characterized by multiple peaks of different sizes. We systematically assess their calibration and short-term forecasting performance in short-term forecasts for the COVID-19 pandemic in the USA from late April 2020 to late February 2022. We compare their performance with two commonly used statistical ARIMA models. The best fit sub-epidemic model and three ensemble models constructed using the top-ranking sub-epidemic models consistently outperformed the ARIMA models in terms of the weighted interval score (WIS) and the coverage of the 95% prediction interval across the 10-, 20-, and 30-day short-term forecasts. In our 30-day forecasts, the average WIS ranged from 377.6 to 421.3 for the sub-epidemic models, whereas it ranged from 439.29 to 767.05 for the ARIMA models. Across 98 short-term forecasts, the ensemble model incorporating the top four ranking sub-epidemic models (Ensemble(4)) outperformed the (log) ARIMA model 66.3% of the time, and the ARIMA model, 69.4% of the time in 30-day ahead forecasts in terms of the WIS. Ensemble(4) consistently yielded the best performance in terms of the metrics that account for the uncertainty of the predictions. This framework can be readily applied to investigate the spread of epidemics and pandemics beyond COVID-19, as well as other dynamic growth processes found in nature and society that would benefit from short-term predictions.
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14
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Zhang Y, Zhang Q, Zhao Y, Deng Y, Zheng H. Urban spatial risk prediction and optimization analysis of POI based on deep learning from the perspective of an epidemic. INTERNATIONAL JOURNAL OF APPLIED EARTH OBSERVATION AND GEOINFORMATION : ITC JOURNAL 2022; 112:102942. [PMID: 35945962 PMCID: PMC9353319 DOI: 10.1016/j.jag.2022.102942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/19/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
From an epidemiological perspective, previous research on COVID-19 has generally been based on classical statistical analyses. As a result, spatial information is often not used effectively. This paper uses image-based neural networks to explore the relationship between urban spatial risk and the distribution of infected populations, and the design of urban facilities. To achieve this objective, we use spatio-temporal data of people infected with new coronary pneumonia prior to 28 February 2020 in Wuhan. We then use kriging, which is a method of spatial interpolation, as well as core density estimation technology to establish the epidemic heat distribution on fine grid units. We further evaluate the influence of nine major spatial risk factors, including the distribution of agencies, hospitals, park squares, sports fields, banks and hotels, by testing them for significant positive correlation with the distribution of the epidemic. The weights of these spatial risk factors are used for training Generative Adversarial Network (GAN) models, which predict the distribution of cases in a given area. The input image for the machine learning model is a city plan converted by public infrastructures, and the output image is a map of urban spatial risk factors in the given area. The results of the trained model demonstrate that optimising the relevant point of interests (POI) in urban areas to effectively control potential risk factors can aid in managing the epidemic and preventing it from dispersing further.
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Affiliation(s)
- Yecheng Zhang
- College of Architecture & Art, Hefei University of Technology, Hefei, China
| | - Qimin Zhang
- School of Mechanical Engineering, Hefei University of Technology, Hefei, China
| | - Yuxuan Zhao
- College of Architecture & Art, Hefei University of Technology, Hefei, China
| | - Yunjie Deng
- College of Architecture & Art, Hefei University of Technology, Hefei, China
| | - Hao Zheng
- Stuart Weitzman School of Design, University of Pennsylvania, Philadelphia, United States
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15
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Ma B, Qi J, Wu Y, Wang P, Li D, Liu S. Parameter estimation of the COVID-19 transmission model using an improved quantum-behaved particle swarm optimization algorithm. DIGITAL SIGNAL PROCESSING 2022; 127:103577. [PMID: 35529477 PMCID: PMC9067002 DOI: 10.1016/j.dsp.2022.103577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The outbreak of coronavirus disease (COVID-19) and its accompanying pandemic have created an unprecedented challenge worldwide. Parametric modeling and analyses of the COVID-19 play a critical role in providing vital information about the character and relevant guidance for controlling the pandemic. However, the epidemiological utility of the results obtained from the COVID-19 transmission model largely depends on accurately identifying parameters. This paper extends the susceptible-exposed-infectious-recovered (SEIR) model and proposes an improved quantum-behaved particle swarm optimization (QPSO) algorithm to estimate its parameters. A new strategy is developed to update the weighting factor of the mean best position by the reciprocal of multiplying the fitness of each best particle with the average fitness of all best particles, which can enhance the global search capacity. To increase the particle diversity, a probability function is designed to generate new particles in the updating iteration. When compared to the state-of-the-art estimation algorithms on the epidemic datasets of China, Italy and the US, the proposed method achieves good accuracy and convergence at a comparable computational complexity. The developed framework would be beneficial for experts to understand the characteristics of epidemic development and formulate epidemic prevention and control measures.
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Affiliation(s)
- Baoshan Ma
- School of Information Science and Technology, Dalian Maritime University, Dalian, 116026, China
| | - Jishuang Qi
- School of Information Science and Technology, Dalian Maritime University, Dalian, 116026, China
| | - Yiming Wu
- School of Information Science and Technology, Dalian Maritime University, Dalian, 116026, China
| | - Pengcheng Wang
- Department of Mechanical Engineering, University of Houston, Houston, TX, 77204, USA
| | - Di Li
- Department of Neuro Intervention, Dalian Medical University affiliated Dalian Municipal Central Hospital, Dalian, 116033, China
| | - Shuxin Liu
- Department of Nephrology, Dalian Medical University affiliated Dalian Municipal Central Hospital, Dalian, 116033, China
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16
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Chowell G, Dahal S, Tariq A, Roosa K, Hyman JM, Luo R. An ensemble n -sub-epidemic modeling framework for short-term forecasting epidemic trajectories: Application to the COVID-19 pandemic in the USA. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.06.19.22276608. [PMID: 35794886 PMCID: PMC9258290 DOI: 10.1101/2022.06.19.22276608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We analyze an ensemble of n -sub-epidemic modeling for forecasting the trajectory of epidemics and pandemics. These ensemble modeling approaches, and models that integrate sub-epidemics to capture complex temporal dynamics, have demonstrated powerful forecasting capability. This modeling framework can characterize complex epidemic patterns, including plateaus, epidemic resurgences, and epidemic waves characterized by multiple peaks of different sizes. We systematically assess their calibration and short-term forecasting performance in short-term forecasts for the COVID-19 pandemic in the USA from late April 2020 to late February 2022. We compare their performance with two commonly used statistical ARIMA models. The best fit sub-epidemic model and three ensemble models constructed using the top-ranking sub-epidemic models consistently outperformed the ARIMA models in terms of the weighted interval score (WIS) and the coverage of the 95% prediction interval across the 10-, 20-, and 30-day short-term forecasts. In the 30-day forecasts, the average WIS ranged from 377.6 to 421.3 for the sub-epidemic models, whereas it ranged from 439.29 to 767.05 for the ARIMA models. Across 98 short-term forecasts, the ensemble model incorporating the top four ranking sub-epidemic models (Ensemble(4)) outperformed the (log) ARIMA model 66.3% of the time, and the ARIMA model 69.4% of the time in 30-day ahead forecasts in terms of the WIS. Ensemble(4) consistently yielded the best performance in terms of the metrics that account for the uncertainty of the predictions. This framework could be readily applied to investigate the spread of epidemics and pandemics beyond COVID-19, as well as other dynamic growth processes found in nature and society that would benefit from short-term predictions. Summary The COVID-19 pandemic has highlighted the urgent need to develop reliable tools to forecast the trajectory of epidemics and pandemics in near real-time. We describe and apply an ensemble n -sub-epidemic modeling framework for forecasting the trajectory of epidemics and pandemics. We systematically assess its calibration and short-term forecasting performance in weekly 10-30 days ahead forecasts for the COVID-19 pandemic in the USA from late April 2020 to late February 2022 and compare its performance with two different statistical ARIMA models. This framework demonstrated reliable forecasting performance and substantially outcompeted the ARIMA models. The forecasting performance was consistently best for the ensemble sub-epidemic models incorporating a higher number of top-ranking sub-epidemic models. The ensemble model incorporating the top four ranking sub-epidemic models consistently yielded the best performance, particularly in terms of the coverage rate of the 95% prediction interval and the weighted interval score. This framework can be applied to forecast other growth processes found in nature and society including the spread of information through social media.
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Affiliation(s)
- Gerardo Chowell
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Sushma Dahal
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Amna Tariq
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Kimberlyn Roosa
- National Institute for Mathematical and Biological Synthesis (NIMBioS), University of Tennessee, Knoxville, TN, USA
| | - James M Hyman
- Department of Mathematics, Center for Computational Science, Tulane University, New Orleans, LA, USA
| | - Ruiyan Luo
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
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17
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Morsi SA, Alzahrani ME. Advanced Computing Approach for Modeling and Prediction COVID-19 Pandemic. Appl Bionics Biomech 2022; 2022:6056574. [PMID: 35432594 PMCID: PMC9011169 DOI: 10.1155/2022/6056574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/04/2022] [Accepted: 03/24/2022] [Indexed: 11/18/2022] Open
Abstract
The emergence of many strains of the coronavirus, including the latest omicron strain, which is spreading at a very high speed, is leading to the World Health Organization's (WHO) concern about the creation of this new mutation. Therefore, there is a strong motivation for modeling and predicting COVID-19 to control the number of cases of the disease. The proposed system for predicting the number of cases of COVID-19 can help governments take precautions to prevent the spread of the disease. In this paper, a statistical logistic growth model was employed to predict the spread of COVID-19 in Australia and Brazil. The datasets were collected from the surveillance systems in Australia and Brazil from March 13, 2020, to December 12, 2021, for 641 days. This proposed method used a tested logistic growth model for the complex spread of COVID-19 and forecasted future values within a time interval of six days. The results of the predicted, cumulative, confirmed cases indicate the robustness and effectiveness of the proposed system, which was categorized by time-dependent dynamics. The coefficient of determination (R) metric was used to evaluate the model to predict COVID-19, and the proposed system scored the highest correlation (R 2 = 99%). The proposed system has the potential to contribute to public health by making decisions about how to prevent the spread of COVID-19.
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Affiliation(s)
- Sami A. Morsi
- Applied College in Abqaiq, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia
- Al-Neelain University, Sudan
| | - Mohammad Eid Alzahrani
- Faculty of Computer Science and Information Technology, Al Baha University, Saudi Arabia
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18
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Delli Compagni R, Cheng Z, Russo S, Van Boeckel TP. A hybrid Neural Network-SEIR model for forecasting intensive care occupancy in Switzerland during COVID-19 epidemics. PLoS One 2022; 17:e0263789. [PMID: 35239662 PMCID: PMC8893679 DOI: 10.1371/journal.pone.0263789] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 01/26/2022] [Indexed: 12/05/2022] Open
Abstract
Anticipating intensive care unit (ICU) occupancy is critical in supporting decision makers to impose (or relax) measures that mitigate COVID-19 transmission. Mechanistic approaches such as Susceptible-Infected-Recovered (SIR) models have traditionally been used to achieve this objective. However, formulating such models is challenged by the necessity to formulate equations for plausible causal mechanisms between the intensity of COVID-19 transmission and external epidemic drivers such as temperature, and the stringency of non-pharmaceutical interventions. Here, we combined a neural network model (NN) with a Susceptible-Exposed-Infected-Recovered model (SEIR) in a hybrid model and attempted to increase the prediction accuracy of existing models used to forecast ICU occupancy. Between 1st of October, 2020 - 1st of July, 2021, the hybrid model improved performances of the SEIR model at different geographical levels. At a national level, the hybrid model improved, prediction accuracy (i.e., mean absolute error) by 74%. At the cantonal and hospital levels, the reduction on the forecast's mean absolute error were 46% and 50%, respectively. Our findings illustrate those predictions from hybrid model can be used to anticipate occupancy in ICU, and support the decision-making for lifesaving actions such as the transfer of patients and dispatching of medical personnel and ventilators.
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Affiliation(s)
| | - Zhao Cheng
- Health Geography and Policy Group, ETH Zürich, Zürich, Switzerland
| | - Stefania Russo
- Ecovision Lab, Photogrammetry and Remote Sensing, ETH Zürich, Zürich, Switzerland
| | - Thomas P. Van Boeckel
- Health Geography and Policy Group, ETH Zürich, Zürich, Switzerland
- Center for Diseases Dynamics Economics and Policy, Washington, DC, United States of America
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19
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Abstract
Accurate forecasts of the number of newly infected people during an epidemic are critical for making effective timely decisions. This paper addresses this challenge using the SIMLR model, which incorporates machine learning (ML) into the epidemiological SIR model. For each region, SIMLR tracks the changes in the policies implemented at the government level, which it uses to estimate the time-varying parameters of an SIR model for forecasting the number of new infections one to four weeks in advance. It also forecasts the probability of changes in those government policies at each of these future times, which is essential for the longer-range forecasts. We applied SIMLR to data from in Canada and the United States, and show that its mean average percentage error is as good as state-of-the-art forecasting models, with the added advantage of being an interpretable model. We expect that this approach will be useful not only for forecasting COVID-19 infections, but also in predicting the evolution of other infectious diseases.
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20
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Guzman-Vilca WC, Castillo-Cara M, Carrillo-Larco RM. Development, validation and application of a machine learning model to estimate salt consumption in 54 countries. eLife 2022; 11:72930. [PMID: 34984979 PMCID: PMC8789317 DOI: 10.7554/elife.72930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022] Open
Abstract
Global targets to reduce salt intake have been proposed but their monitoring is challenged by the lack of population-based data on salt consumption. We developed a machine learning (ML) model to predict salt consumption at the population level based on simple predictors and applied this model to national surveys in 54 countries. We used 21 surveys with spot urine samples for the ML model derivation and validation; we developed a supervised ML regression model based on: sex, age, weight, height, systolic and diastolic blood pressure. We applied the ML model to 54 new surveys to quantify the mean salt consumption in the population. The pooled dataset in which we developed the ML model included 49,776 people. Overall, there were no substantial differences between the observed and ML-predicted mean salt intake (p<0.001). The pooled dataset where we applied the ML model included 166,677 people; the predicted mean salt consumption ranged from 6.8 g/day (95% CI: 6.8-6.8 g/day) in Eritrea to 10.0 g/day (95% CI: 9.9-10.0 g/day) in American Samoa. The countries with the highest predicted mean salt intake were in Western Pacific. The lowest predicted intake was found in Africa. The country-specific predicted mean salt intake was within reasonable difference from the best available evidence. A ML model based on readily available predictors estimated daily salt consumption with good accuracy. This model could be used to predict mean salt consumption in the general population where urine samples are not available.
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21
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Giancotti M, Lopreite M, Mauro M, Puliga M. The role of European health system characteristics in affecting Covid 19 lethality during the early days of the pandemic. Sci Rep 2021; 11:23739. [PMID: 34887452 PMCID: PMC8660820 DOI: 10.1038/s41598-021-03120-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 11/26/2021] [Indexed: 12/21/2022] Open
Abstract
This article examines the main factors affecting COVID-19 lethality across 16 European Countries with a focus on the role of health system characteristics during the first phase of the diffusion of the virus. Specifically, we investigate the leading causes of lethality at 10, 20, 30, 40 days in the first hit of the pandemic. Using a random forest regression (ML), with lethality as outcome variable, we show that the percentage of people older than 65 years (with two or more chronic diseases) is the main predictor variable of lethality by COVID-19, followed by the number of hospital intensive care unit beds, investments in healthcare spending compared to GDP, number of nurses and doctors. Moreover, the variable of general practitioners has little but significant predicting quality. These findings contribute to provide evidence for the prediction of lethality caused by COVID-19 in Europe and open the discussion on health policy and management of health care and ICU beds during a severe epidemic.
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Affiliation(s)
- Monica Giancotti
- Department of Clinical and Experimental Medicine, Magna Graecia University, Viale Europa, Catanzaro, Italy
| | - Milena Lopreite
- Department of Economics, Statistics and Finance, University of Calabria, Calabria, Italy.
| | - Marianna Mauro
- Department of Clinical and Experimental Medicine, Magna Graecia University, Catanzaro, Italy
| | - Michelangelo Puliga
- Institute of Management, Sant'Anna School of Advanced Studies, Pisa, Italy
- Linkalab Computational Laboratory, Cagliari, Italy
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22
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Spinella C, Mio AM. Simulation of the impact of people mobility, vaccination rate, and virus variants on the evolution of Covid-19 outbreak in Italy. Sci Rep 2021; 11:23225. [PMID: 34853368 PMCID: PMC8636642 DOI: 10.1038/s41598-021-02546-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 11/11/2021] [Indexed: 12/13/2022] Open
Abstract
We have further extended our compartmental model describing the spread of the infection in Italy. As in our previous work, the model assumes that the time evolution of the observable quantities (number of people still positive to the infection, hospitalized and fatalities cases, healed people, and total number of people that has contracted the infection) depends on average parameters, namely people diffusion coefficient, infection cross-section, and population density. The model provides information on the tight relationship between the variation of the reported infection cases and a well-defined observable physical quantity: the average number of people that lie within the daily displacement area of any single person. With respect to our previous paper, we have extended the analyses to several regions in Italy, characterized by different levels of restrictions and we have correlated them to the diffusion coefficient. Furthermore, the model now includes self-consistent evaluation of the reproduction index, effect of immunization due to vaccination, and potential impact of virus variants on the dynamical evolution of the outbreak. The model fits the epidemic data in Italy, and allows us to strictly relate the time evolution of the number of hospitalized cases and fatalities to the change of people mobility, vaccination rate, and appearance of an initial concentration of people positives for new variants of the virus.
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Affiliation(s)
- Corrado Spinella
- Dipartimento di Scienze Fisiche e Tecnologie per la Materia, Consiglio Nazionale delle Ricerche, Piazzale Aldo Moro 7, 00185, Rome, Italy
| | - Antonio Massimiliano Mio
- Dipartimento di Scienze Fisiche e Tecnologie per la Materia, Consiglio Nazionale delle Ricerche, Piazzale Aldo Moro 7, 00185, Rome, Italy. .,Institute for Microelectronics and Microsystems (IMM), Consiglio Nazionale delle Ricerche (CNR), VIII Strada 5, I-95121, Catania, Italy.
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23
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Forecasting COVID-19 infections in the Arabian Gulf region. MODELING EARTH SYSTEMS AND ENVIRONMENT 2021; 8:3813-3822. [PMID: 34778510 PMCID: PMC8571680 DOI: 10.1007/s40808-021-01332-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/22/2021] [Indexed: 11/19/2022]
Abstract
In this paper, an empirical analysis of linear state space models and long short-term memory neural networks is performed to compare the statistical performance of these models in predicting the spread of COVID-19 infections. Data on the pandemic daily infections from the Arabian Gulf countries from 2020/03/24 to 2021/05/20 are fitted to each model and a statistical analysis is conducted to assess their short-term prediction accuracy. The results show that state space model predictions are more accurate with notably smaller root mean square errors than the deep learning forecasting method. The results also indicate that the poorer forecast performance of long short-term memory neural networks occurs in particular when health surveillance data are characterized by high fluctuations of the daily infection records and frequent occurrences of abrupt changes. One important result of this study is the possible relationship between data complexity and forecast accuracy with different models as suggested in the entropy analysis. It is concluded that state space models perform better than long short-term memory networks with highly irregular and more complex surveillance data.
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24
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Hernández-Pereira E, Fontenla-Romero O, Bolón-Canedo V, Cancela-Barizo B, Guijarro-Berdiñas B, Alonso-Betanzos A. Machine learning techniques to predict different levels of hospital care of CoVid-19. APPL INTELL 2021; 52:6413-6431. [PMID: 34764619 PMCID: PMC8429889 DOI: 10.1007/s10489-021-02743-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 11/25/2022]
Abstract
In this study, we analyze the capability of several state of the art machine learning methods to predict whether patients diagnosed with CoVid-19 (CoronaVirus disease 2019) will need different levels of hospital care assistance (regular hospital admission or intensive care unit admission), during the course of their illness, using only demographic and clinical data. For this research, a data set of 10,454 patients from 14 hospitals in Galicia (Spain) was used. Each patient is characterized by 833 variables, two of which are age and gender and the other are records of diseases or conditions in their medical history. In addition, for each patient, his/her history of hospital or intensive care unit (ICU) admissions due to CoVid-19 is available. This clinical history will serve to label each patient and thus being able to assess the predictions of the model. Our aim is to identify which model delivers the best accuracies for both hospital and ICU admissions only using demographic variables and some structured clinical data, as well as identifying which of those are more relevant in both cases. The results obtained in the experimental study show that the best models are those based on oversampling as a preprocessing phase to balance the distribution of classes. Using these models and all the available features, we achieved an area under the curve (AUC) of 76.1% and 80.4% for predicting the need of hospital and ICU admissions, respectively. Furthermore, feature selection and oversampling techniques were applied and it has been experimentally verified that the relevant variables for the classification are age and gender, since only using these two features the performance of the models is not degraded for the two mentioned prediction problems.
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Affiliation(s)
- Elena Hernández-Pereira
- Universidade da Coruña. CITIC Research and Development Laboratory in Artificial Intelligence (LIDIA) Facultad de informática, Campus de Elviña s/n. A, Coruña, Spain
| | - Oscar Fontenla-Romero
- Universidade da Coruña. CITIC Research and Development Laboratory in Artificial Intelligence (LIDIA) Facultad de informática, Campus de Elviña s/n. A, Coruña, Spain
| | - Verónica Bolón-Canedo
- Universidade da Coruña. CITIC Research and Development Laboratory in Artificial Intelligence (LIDIA) Facultad de informática, Campus de Elviña s/n. A, Coruña, Spain
| | - Brais Cancela-Barizo
- Universidade da Coruña. CITIC Research and Development Laboratory in Artificial Intelligence (LIDIA) Facultad de informática, Campus de Elviña s/n. A, Coruña, Spain
| | - Bertha Guijarro-Berdiñas
- Universidade da Coruña. CITIC Research and Development Laboratory in Artificial Intelligence (LIDIA) Facultad de informática, Campus de Elviña s/n. A, Coruña, Spain
| | - Amparo Alonso-Betanzos
- Universidade da Coruña. CITIC Research and Development Laboratory in Artificial Intelligence (LIDIA) Facultad de informática, Campus de Elviña s/n. A, Coruña, Spain
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25
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Asada K, Komatsu M, Shimoyama R, Takasawa K, Shinkai N, Sakai A, Bolatkan A, Yamada M, Takahashi S, Machino H, Kobayashi K, Kaneko S, Hamamoto R. Application of Artificial Intelligence in COVID-19 Diagnosis and Therapeutics. J Pers Med 2021; 11:886. [PMID: 34575663 PMCID: PMC8471764 DOI: 10.3390/jpm11090886] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 12/12/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic began at the end of December 2019, giving rise to a high rate of infections and causing COVID-19-associated deaths worldwide. It was first reported in Wuhan, China, and since then, not only global leaders, organizations, and pharmaceutical/biotech companies, but also researchers, have directed their efforts toward overcoming this threat. The use of artificial intelligence (AI) has recently surged internationally and has been applied to diverse aspects of many problems. The benefits of using AI are now widely accepted, and many studies have shown great success in medical research on tasks, such as the classification, detection, and prediction of disease, or even patient outcome. In fact, AI technology has been actively employed in various ways in COVID-19 research, and several clinical applications of AI-equipped medical devices for the diagnosis of COVID-19 have already been reported. Hence, in this review, we summarize the latest studies that focus on medical imaging analysis, drug discovery, and therapeutics such as vaccine development and public health decision-making using AI. This survey clarifies the advantages of using AI in the fight against COVID-19 and provides future directions for tackling the COVID-19 pandemic using AI techniques.
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Affiliation(s)
- Ken Asada
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; (K.A.); (M.K.); (R.S.); (K.T.); (N.S.); (A.B.); (S.T.); (H.M.); (K.K.); (S.K.)
- Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (A.S.); (M.Y.)
| | - Masaaki Komatsu
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; (K.A.); (M.K.); (R.S.); (K.T.); (N.S.); (A.B.); (S.T.); (H.M.); (K.K.); (S.K.)
- Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (A.S.); (M.Y.)
| | - Ryo Shimoyama
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; (K.A.); (M.K.); (R.S.); (K.T.); (N.S.); (A.B.); (S.T.); (H.M.); (K.K.); (S.K.)
- Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (A.S.); (M.Y.)
| | - Ken Takasawa
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; (K.A.); (M.K.); (R.S.); (K.T.); (N.S.); (A.B.); (S.T.); (H.M.); (K.K.); (S.K.)
- Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (A.S.); (M.Y.)
| | - Norio Shinkai
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; (K.A.); (M.K.); (R.S.); (K.T.); (N.S.); (A.B.); (S.T.); (H.M.); (K.K.); (S.K.)
- Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (A.S.); (M.Y.)
- Department of NCC Cancer Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Akira Sakai
- Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (A.S.); (M.Y.)
- Department of NCC Cancer Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Amina Bolatkan
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; (K.A.); (M.K.); (R.S.); (K.T.); (N.S.); (A.B.); (S.T.); (H.M.); (K.K.); (S.K.)
- Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (A.S.); (M.Y.)
| | - Masayoshi Yamada
- Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (A.S.); (M.Y.)
- Department of Endoscopy, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Satoshi Takahashi
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; (K.A.); (M.K.); (R.S.); (K.T.); (N.S.); (A.B.); (S.T.); (H.M.); (K.K.); (S.K.)
- Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (A.S.); (M.Y.)
| | - Hidenori Machino
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; (K.A.); (M.K.); (R.S.); (K.T.); (N.S.); (A.B.); (S.T.); (H.M.); (K.K.); (S.K.)
- Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (A.S.); (M.Y.)
| | - Kazuma Kobayashi
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; (K.A.); (M.K.); (R.S.); (K.T.); (N.S.); (A.B.); (S.T.); (H.M.); (K.K.); (S.K.)
- Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (A.S.); (M.Y.)
| | - Syuzo Kaneko
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; (K.A.); (M.K.); (R.S.); (K.T.); (N.S.); (A.B.); (S.T.); (H.M.); (K.K.); (S.K.)
- Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (A.S.); (M.Y.)
| | - Ryuji Hamamoto
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; (K.A.); (M.K.); (R.S.); (K.T.); (N.S.); (A.B.); (S.T.); (H.M.); (K.K.); (S.K.)
- Division of Medical AI Research and Development, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (A.S.); (M.Y.)
- Department of NCC Cancer Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
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Gunawardana M, Breslin J, Cortez JM, Rivera S, Webster S, Ibarrondo FJ, Yang OO, Pyles RB, Ramirez CM, Adler AP, Anton PA, Baum MM. Longitudinal COVID-19 Surveillance and Characterization in the Workplace with Public Health and Diagnostic Endpoints. mSphere 2021; 6:e0054221. [PMID: 34232081 PMCID: PMC8386432 DOI: 10.1128/msphere.00542-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 02/08/2023] Open
Abstract
Public health practices and high vaccination rates currently represent the primary interventions for managing the spread of coronavirus disease 2019 (COVID-19). We initiated a clinical study based on frequent, longitudinal workplace disease surveillance to control severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission among employees and their household members. We hypothesized that the study would reduce the economic burden and loss of productivity of both individuals and small businesses resulting from standard isolation methods, while providing new insights into virus-host dynamics. Study participants (27 employees and 27 household members) consented to provide frequent nasal or oral swab samples that were analyzed by reverse transcription-quantitative PCR (RT-qPCR) for SARS-CoV-2 RNA. Two study participants were found to be infected by SARS-CoV-2 during the study. One subject, a household member, was SARS-CoV-2 RNA positive for at least 71 days and had quantifiable serum virus-specific antibody concentrations for over 1 year. One unrelated employee became positive for SARS-CoV-2 RNA over the course of the study but remained asymptomatic, with low associated viral RNA copy numbers, no detectable serum IgM and IgG concentrations, and IgA concentrations that decayed rapidly (half-life: 1.3 days). A COVID-19 infection model was used to predict that without surveillance intervention, up to 7 employees (95% confidence interval [CI] = 3 to 10) would have become infected, with at most 1 of them requiring hospitalization. Our scalable and transferable surveillance plan met its primary objectives and represents a powerful example of an innovative public health initiative dovetailed with scientific discovery. IMPORTANCE The rapid spread of SARS-CoV-2 and the associated COVID-19 has precipitated a global pandemic heavily challenging our social behavior, economy, and health care infrastructure. In the absence of widespread, worldwide access to safe and effective vaccines and therapeutics, public health measures represent a key intervention for curbing the devastating impacts from the pandemic. We are conducting an ongoing clinical study based on frequent, longitudinal workplace disease surveillance to control SARS-CoV-2 transmission among employees and their household members. Our study was successful in surveying the viral and immune response dynamics in two participants with unusual infections: one remained positive for SARS-CoV-2 for 71 days, while the other was asymptomatic, with low associated viral RNA copy numbers. A COVID-19 infection model was used to predict that without surveillance intervention, up to 7 employees would have become infected, with at most 1 of them requiring hospitalization, underscoring the importance of our program.
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Affiliation(s)
- Manjula Gunawardana
- Department of Chemistry, Oak Crest Institute of Science, Monrovia, California, USA
| | - Jessica Breslin
- Department of Chemistry, Oak Crest Institute of Science, Monrovia, California, USA
| | - John M. Cortez
- Department of Chemistry, Oak Crest Institute of Science, Monrovia, California, USA
| | - Sofia Rivera
- Department of Chemistry, Oak Crest Institute of Science, Monrovia, California, USA
| | - Simon Webster
- Department of Chemistry, Oak Crest Institute of Science, Monrovia, California, USA
| | - F. Javier Ibarrondo
- University of California, Los Angeles, Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Otto O. Yang
- University of California, Los Angeles, Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- University of California, Los Angeles, Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Richard B. Pyles
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Christina M. Ramirez
- University of California, Los Angeles, Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Amy P. Adler
- Jumpstart Research Consulting, LLC, Santa Fe, New Mexico, USA
| | - Peter A. Anton
- Department of Chemistry, Oak Crest Institute of Science, Monrovia, California, USA
| | - Marc M. Baum
- Department of Chemistry, Oak Crest Institute of Science, Monrovia, California, USA
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Syrowatka A, Kuznetsova M, Alsubai A, Beckman AL, Bain PA, Craig KJT, Hu J, Jackson GP, Rhee K, Bates DW. Leveraging artificial intelligence for pandemic preparedness and response: a scoping review to identify key use cases. NPJ Digit Med 2021; 4:96. [PMID: 34112939 PMCID: PMC8192906 DOI: 10.1038/s41746-021-00459-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/26/2021] [Indexed: 02/05/2023] Open
Abstract
Artificial intelligence (AI) represents a valuable tool that could be widely used to inform clinical and public health decision-making to effectively manage the impacts of a pandemic. The objective of this scoping review was to identify the key use cases for involving AI for pandemic preparedness and response from the peer-reviewed, preprint, and grey literature. The data synthesis had two parts: an in-depth review of studies that leveraged machine learning (ML) techniques and a limited review of studies that applied traditional modeling approaches. ML applications from the in-depth review were categorized into use cases related to public health and clinical practice, and narratively synthesized. One hundred eighty-three articles met the inclusion criteria for the in-depth review. Six key use cases were identified: forecasting infectious disease dynamics and effects of interventions; surveillance and outbreak detection; real-time monitoring of adherence to public health recommendations; real-time detection of influenza-like illness; triage and timely diagnosis of infections; and prognosis of illness and response to treatment. Data sources and types of ML that were useful varied by use case. The search identified 1167 articles that reported on traditional modeling approaches, which highlighted additional areas where ML could be leveraged for improving the accuracy of estimations or projections. Important ML-based solutions have been developed in response to pandemics, and particularly for COVID-19 but few were optimized for practical application early in the pandemic. These findings can support policymakers, clinicians, and other stakeholders in prioritizing research and development to support operationalization of AI for future pandemics.
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Affiliation(s)
- Ania Syrowatka
- Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | | | - Ava Alsubai
- Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Adam L Beckman
- Harvard Medical School, Boston, MA, USA
- Harvard Business School, Boston, MA, USA
| | - Paul A Bain
- Countway Library of Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Jianying Hu
- IBM Research, Center for Computational Health, Yorktown Heights, NY, USA
| | - Gretchen Purcell Jackson
- IBM Watson Health, Cambridge, MA, USA
- Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kyu Rhee
- IBM Watson Health, Cambridge, MA, USA
- CVS Health, Wellesley Hills, MA, USA
| | - David W Bates
- Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
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