Optimised genetic algorithm-extreme learning machine approach for automatic COVID-19 detection

Genetic Algorithms for Feature Selection in the Classification of COVID-19 Patients

BACKGROUND

Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2) infection can cause feared consequences, such as affecting microcirculatory activity. The combined use of HRV analysis, genetic algorithms, and machine learning classifiers can be helpful in better understanding the characteristics of microcirculation that are mainly affected by COVID-19 infection.

METHODS

This study aimed to verify the presence of microcirculation alterations in patients with COVID-19 infection, performing Heart Rate Variability (HRV) parameters analysis extracted from PhotoPlethysmoGraphy (PPG) signals. The dataset included 97 subjects divided into two groups: healthy (50 subjects) and patients affected by mild-severity COVID-19 (47 subjects). A total of 26 parameters were extracted by the HRV analysis and were investigated using genetic algorithms with three different subject selection methods and five different machine learning classifiers.

RESULTS

Three parameters: meanRR, alpha1, and sd2/sd1 were considered significant, combining the results obtained by the genetic algorithm. Finally, machine learning classifications were performed by training classifiers with only those three features. The best result was achieved by the binary Decision Tree classifier, achieving accuracy of 82%, specificity (or precision) of 86%, and sensitivity of 79%.

CONCLUSIONS

The study's results highlight the ability to use HRV parameters extraction from PPG signals, combined with genetic algorithms and machine learning classifiers, to determine which features are most helpful in discriminating between healthy and mild-severity COVID-19-affected subjects.

Deep Learning Methods for Interpretation of Pulmonary CT and X-ray Images in Patients with COVID-19-Related Lung Involvement: A Systematic Review

SARS-CoV-2 is a novel virus that has been affecting the global population by spreading rapidly and causing severe complications, which require prompt and elaborate emergency treatment. Automatic tools to diagnose COVID-19 could potentially be an important and useful aid. Radiologists and clinicians could potentially rely on interpretable AI technologies to address the diagnosis and monitoring of COVID-19 patients. This paper aims to provide a comprehensive analysis of the state-of-the-art deep learning techniques for COVID-19 classification. The previous studies are methodically evaluated, and a summary of the proposed convolutional neural network (CNN)-based classification approaches is presented. The reviewed papers have presented a variety of CNN models and architectures that were developed to provide an accurate and quick automatic tool to diagnose the COVID-19 virus based on presented CT scan or X-ray images. In this systematic review, we focused on the critical components of the deep learning approach, such as network architecture, model complexity, parameter optimization, explainability, and dataset/code availability. The literature search yielded a large number of studies over the past period of the virus spread, and we summarized their past efforts. State-of-the-art CNN architectures, with their strengths and weaknesses, are discussed with respect to diverse technical and clinical evaluation metrics to safely implement current AI studies in medical practice.

Breast cancer diagnosis using the fast learning network algorithm

The use of machine learning (ML) and data mining algorithms in the diagnosis of breast cancer (BC) has recently received a lot of attention. The majority of these efforts, however, still require improvement since either they were not statistically evaluated or they were evaluated using insufficient assessment metrics, or both. One of the most recent and effective ML algorithms, fast learning network (FLN), may be seen as a reputable and efficient approach for classifying data; however, it has not been applied to the problem of BC diagnosis. Therefore, this study proposes the FLN algorithm in order to improve the accuracy of the BC diagnosis. The FLN algorithm has the capability to a) eliminate overfitting, b) solve the issues of both binary and multiclass classification, and c) perform like a kernel-based support vector machine with a structure of the neural network. In this study, two BC databases (Wisconsin Breast Cancer Database (WBCD) and Wisconsin Diagnostic Breast Cancer (WDBC)) were used to assess the performance of the FLN algorithm. The results of the experiment demonstrated the great performance of the suggested FLN method, which achieved an average of accuracy 98.37%, precision 95.94%, recall 99.40%, F-measure 97.64%, G-mean 97.65%, MCC 96.44%, and specificity 97.85% using the WBCD, as well as achieved an average of accuracy 96.88%, precision 94.84%, recall 96.81%, F-measure 95.80%, G-mean 95.81%, MCC 93.35%, and specificity 96.96% using the WDBC database. This suggests that the FLN algorithm is a reliable classifier for diagnosing BC and may be useful for resolving other application-related problems in the healthcare sector.

Ensemble deep honey architecture for COVID-19 prediction using CT scan and chest X-ray images

Recently, the infectious disease COVID-19 remains to have a catastrophic effect on the lives of human beings all over the world. To combat this deadliest disease, it is essential to screen the affected people quickly and least inexpensively. Radiological examination is considered the most feasible step toward attaining this objective; however, chest X-ray (CXR) and computed tomography (CT) are the most easily accessible and inexpensive options. This paper proposes a novel ensemble deep learning-based solution to predict the COVID-19-positive patients using CXR and CT images. The main aim of the proposed model is to provide an effective COVID-19 prediction model with a robust diagnosis and increase the prediction performance. Initially, pre-processing, like image resizing and noise removal, is employed using image scaling and median filtering techniques to enhance the input data for further processing. Various data augmentation styles, such as flipping and rotation, are applied to capable the model to learn the variations during training and attain better results on a small dataset. Finally, a new ensemble deep honey architecture (EDHA) model is introduced to effectively classify the COVID-19-positive and -negative cases. EDHA combines three pre-trained architectures like ShuffleNet, SqueezeNet, and DenseNet-201, to detect the class value. Moreover, a new optimization algorithm, the honey badger algorithm (HBA), is adapted in EDHA to determine the best values for the hyper-parameters of the proposed model. The proposed EDHA is implemented in the Python platform and evaluates the performance in terms of accuracy, sensitivity, specificity, precision, f1-score, AUC, and MCC. The proposed model has utilized the publicly available CXR and CT datasets to test the solution's efficiency. As a result, the simulated outcomes showed that the proposed EDHA had achieved better performance than the existing techniques in terms of Accuracy, Sensitivity, Specificity, Precision, F1-Score, MCC, AUC, and Computation time are 99.1%, 99%, 98.6%, 99.6%, 98.9%, 99.2%, 0.98, and 820 s using the CXR dataset.

Fruit-CoV: An efficient vision-based framework for speedy detection and diagnosis of SARS-CoV-2 infections through recorded cough sounds

COVID-19 is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This deadly virus has spread worldwide, leading to a global pandemic since March 2020. A recent variant of SARS-CoV-2 named Delta is intractably contagious and responsible for more than four million deaths globally. Therefore, developing an efficient self-testing service for SARS-CoV-2 at home is vital. In this study, a two-stage vision-based framework, namely Fruit-CoV, is introduced for detecting SARS-CoV-2 infections through recorded cough sounds. Specifically, audio signals are converted into Log-Mel spectrograms, and the EfficientNet-V2 network is used to extract their visual features in the first stage. In the second stage, 14 convolutional layers extracted from the large-scale Pretrained Audio Neural Networks for audio pattern recognition (PANNs) and the Wavegram-Log-Mel-CNN are employed to aggregate feature representations of the Log-Mel spectrograms and the waveform. Finally, the combined features are used to train a binary classifier. In this study, a dataset provided by the AICovidVN 115M Challenge is employed for evaluation. It includes 7,371 recorded cough sounds collected throughout Vietnam, India, and Switzerland. Experimental results indicate that the proposed model achieves an Area Under the Receiver Operating Characteristic Curve (AUC) score of 92.8% and ranks first on the final leaderboard of the AICovidVN 115M Challenge. Our code is publicly available.

Classifying COVID-19 Patients From Chest X-ray Images Using Hybrid Machine Learning Techniques: Development and Evaluation

BACKGROUND

The COVID-19 pandemic has raised global concern, with moderate to severe cases displaying lung inflammation and respiratory failure. Chest x-ray (CXR) imaging is crucial for diagnosis and is usually interpreted by experienced medical specialists. Machine learning has been applied with acceptable accuracy, but computational efficiency has received less attention.

OBJECTIVE

We introduced a novel hybrid machine learning model to accurately classify COVID-19, non-COVID-19, and healthy patients from CXR images with reduced computational time and promising results. Our proposed model was thoroughly evaluated and compared with existing models.

METHODS

A retrospective study was conducted to analyze 5 public data sets containing 4200 CXR images using machine learning techniques including decision trees, support vector machines, and neural networks. The images were preprocessed to undergo image segmentation, enhancement, and feature extraction. The best performing machine learning technique was selected and combined into a multilayer hybrid classification model for COVID-19 (MLHC-COVID-19). The model consisted of 2 layers. The first layer was designed to differentiate healthy individuals from infected patients, while the second layer aimed to classify COVID-19 and non-COVID-19 patients.

RESULTS

The MLHC-COVID-19 model was trained and evaluated on unseen COVID-19 CXR images, achieving reasonably high accuracy and F measures of 0.962 and 0.962, respectively. These results show the effectiveness of the MLHC-COVID-19 in classifying COVID-19 CXR images, with improved accuracy and a reduction in interpretation time. The model was also embedded into a web-based MLHC-COVID-19 computer-aided diagnosis system, which was made publicly available.

CONCLUSIONS

The study found that the MLHC-COVID-19 model effectively differentiated CXR images of COVID-19 patients from those of healthy and non-COVID-19 individuals. It outperformed other state-of-the-art deep learning techniques and showed promising results. These results suggest that the MLHC-COVID-19 model could have been instrumental in early detection and diagnosis of COVID-19 patients, thus playing a significant role in controlling and managing the pandemic. Although the pandemic has slowed down, this model can be adapted and utilized for future similar situations. The model was also integrated into a publicly accessible web-based computer-aided diagnosis system.

Automatic Detection of Severely and Mildly Infected COVID-19 Patients with Supervised Machine Learning Models

Objectives

When the prognosis of COVID-19 disease can be detected early, the intense-pressure and loss of workforce in health-services can be partially reduced. The primary-purpose of this article is to determine the feature-dataset consisting of the routine-blood-values (RBV) and demographic-data that affect the prognosis of COVID-19. Second, by applying the feature-dataset to the supervised machine-learning (ML) models, it is to identify severely and mildly infected COVID-19 patients at the time of admission.

Material and methods

The sample of this study consists of severely (n = 192) and mildly (n = 4010) infected-patients hospitalized with the diagnosis of COVID-19 between March-September, 2021. The RBV-data measured at the time of admission and age-gender characteristics of these patients were analyzed retrospectively. For the selection of the features, the minimum-redundancy-maximum-relevance (MRMR) method, principal-components-analysis and forward-multiple-logistics-regression analyzes were used. The features set were statistically compared between mild and severe infected-patients. Then, the performances of various supervised-ML-models were compared in identifying severely and mildly infected-patients using the feature set.

Results

In this study, 28 RBV-parameters and age-variable were found as the feature-dataset. The effect of features on the prognosis of the disease has been clinically proven. The ML-models with the highest overall-accuracy in identifying patient-groups were found respectively, as follows: local-weighted-learning (LWL)-97.86%, K-star (K*)-96.31%, Naive-Bayes (NB)-95.36% and k-nearest-neighbor (KNN)-94.05%. Also, the most successful models with the highest area-under-the-receiver-operating-characteristic-curve (AUC) values in identifying patient groups were found respectively, as follows: LWL-0.95%, K*-0.91%, NB-0.85% and KNN-0.75%.

Conclusion

The findings in this article have significant a motivation for the healthcare professionals to detect at admission severely and mildly infected COVID-19 patients.

Grayscale Image Statistical Attributes Effectively Distinguish the Severity of Lung Abnormalities in CT Scan Slices of COVID-19 Patients

Grayscale statistical attributes analysed for 513 extract images taken from pulmonary computed tomography (CT) scan slices of 57 individuals (49 confirmed COVID-19 positive; eight confirmed COVID-19 negative) are able to accurately predict a visual score (VS from 0 to 4) used by a clinician to assess the severity of lung abnormalities in the patients. Some of these attributes can be used graphically to distinguish useful but overlapping distributions for the VS classes. Using machine and deep learning (ML/DL) algorithms with twelve grayscale image attributes as inputs enables the VS classes to be accurately distinguished. A convolutional neural network achieves this with better than 96% accuracy (only 18 images misclassified out of 513) on a supervised learning basis. Analysis of confusion matrices enables the VS prediction performance of ML/DL algorithms to be explored in detail. Those matrices demonstrate that the best performing ML/DL algorithms successfully distinguish between VS classes 0 and 1, which clinicians cannot readily do with the naked eye. Just five image grayscale attributes can also be used to generate an algorithmically defined scoring system (AS) that can also graphically distinguish the degree of pulmonary impacts in the dataset evaluated. The AS classification illustrated involves less overlap between its classes than the VS system and could be exploited as an automated expert system. The best-performing ML/DL models are able to predict the AS classes with better than 99% accuracy using twelve grayscale attributes as inputs. The decision tree and random forest algorithms accomplish that distinction with just one classification error in the 513 images tested.

Predicting Risk of Mortality in COVID-19 Hospitalized Patients using Hybrid Machine Learning Algorithms

BACKGROUND

Since hospitalized patients with COVID-19 are considered at high risk of death, the patients with the sever clinical condition should be identified. Despite the potential of machine learning (ML) techniques to predict the mortality of COVID-19 patients, high-dimensional data is considered a challenge, which can be addressed by metaheuristic and nature-inspired algorithms, such as genetic algorithm (GA).

OBJECTIVE

This paper aimed to compare the efficiency of the GA with several ML techniques to predict COVID-19 in-hospital mortality.

MATERIAL AND METHODS

In this retrospective study, 1353 COVID-19 in-hospital patients were examined from February 9 to December 20, 2020. The GA technique was applied to select the important features, then using selected features several ML algorithms such as K-nearest-neighbor (K-NN), Decision Tree (DT), Support Vector Machines (SVM), and Artificial Neural Network (ANN) were trained to design predictive models. Finally, some evaluation metrics were used for the comparison of developed models.

RESULTS

A total of 10 features out of 56 were selected, including length of stay (LOS), age, cough, respiratory intubation, dyspnea, cardiovascular diseases, leukocytosis, blood urea nitrogen (BUN), C-reactive protein, and pleural effusion by 10-independent execution of GA. The GA-SVM had the best performance with the accuracy and specificity of 9.5147e+01 and 9.5112e+01, respectively.

CONCLUSION

The hybrid ML models, especially the GA-SVM, can improve the treatment of COVID-19 patients, predict severe disease and mortality, and optimize the utilization of health resources based on the improvement of input features and the adaption of the structure of the models.

Particle Swarm Optimization-Based Extreme Learning Machine for COVID-19 Detection

COVID-19 (coronavirus disease 2019) is an ongoing global pandemic caused by severe acute respiratory syndrome coronavirus 2. Recently, it has been demonstrated that the voice data of the respiratory system (i.e., speech, sneezing, coughing, and breathing) can be processed via machine learning (ML) algorithms to detect respiratory system diseases, including COVID-19. Consequently, many researchers have applied various ML algorithms to detect COVID-19 by using voice data from the respiratory system. However, most of the recent COVID-19 detection systems have worked on a limited dataset. In other words, the systems utilize cough and breath voices only and ignore the voices of the other respiratory system, such as speech and vowels. In addition, another issue that should be considered in COVID-19 detection systems is the classification accuracy of the algorithm. The particle swarm optimization-extreme learning machine (PSO-ELM) is an ML algorithm that can be considered an accurate and fast algorithm in the process of classification. Therefore, this study proposes a COVID-19 detection system by utilizing the PSO-ELM as a classifier and mel frequency cepstral coefficients (MFCCs) for feature extraction. In this study, respiratory system voice samples were taken from the Corona Hack Respiratory Sound Dataset (CHRSD). The proposed system involves thirteen different scenarios: breath deep, breath shallow, all breath, cough heavy, cough shallow, all cough, count fast, count normal, all count, vowel a, vowel e, vowel o, and all vowels. The experimental results demonstrated that the PSO-ELM was capable of attaining the highest accuracy, reaching 95.83%, 91.67%, 89.13%, 96.43%, 92.86%, 88.89%, 96.15%, 96.43%, 88.46%, 96.15%, 96.15%, 95.83%, and 82.89% for breath deep, breath shallow, all breath, cough heavy, cough shallow, all cough, count fast, count normal, all count, vowel a, vowel e, vowel o, and all vowel scenarios, respectively. The PSO-ELM is an efficient technique for the detection of COVID-19 utilizing voice data from the respiratory system.

Comprehensive Survey of Machine Learning Systems for COVID-19 Detection

The last two years are considered the most crucial and critical period of the COVID-19 pandemic affecting most life aspects worldwide. This virus spreads quickly within a short period, increasing the fatality rate associated with the virus. From a clinical perspective, several diagnosis methods are carried out for early detection to avoid virus propagation. However, the capabilities of these methods are limited and have various associated challenges. Consequently, many studies have been performed for COVID-19 automated detection without involving manual intervention and allowing an accurate and fast decision. As is the case with other diseases and medical issues, Artificial Intelligence (AI) provides the medical community with potential technical solutions that help doctors and radiologists diagnose based on chest images. In this paper, a comprehensive review of the mentioned AI-based detection solution proposals is conducted. More than 200 papers are reviewed and analyzed, and 145 articles have been extensively examined to specify the proposed AI mechanisms with chest medical images. A comprehensive examination of the associated advantages and shortcomings is illustrated and summarized. Several findings are concluded as a result of a deep analysis of all the previous works using machine learning for COVID-19 detection, segmentation, and classification.

Gray wolf optimization-extreme learning machine approach for diabetic retinopathy detection

Many works have employed Machine Learning (ML) techniques in the detection of Diabetic Retinopathy (DR), a disease that affects the human eye. However, the accuracy of most DR detection methods still need improvement. Gray Wolf Optimization-Extreme Learning Machine (GWO-ELM) is one of the most popular ML algorithms, and can be considered as an accurate algorithm in the process of classification, but has not been used in solving DR detection. Therefore, this work aims to apply the GWO-ELM classifier and employ one of the most popular features extractions, Histogram of Oriented Gradients-Principal Component Analysis (HOG-PCA), to increase the accuracy of DR detection system. Although the HOG-PCA has been tested in many image processing domains including medical domains, it has not yet been tested in DR. The GWO-ELM can prevent overfitting, solve multi and binary classifications problems, and it performs like a kernel-based Support Vector Machine with a Neural Network structure, whilst the HOG-PCA has the ability to extract the most relevant features with low dimensionality. Therefore, the combination of the GWO-ELM classifier and HOG-PCA features might produce an effective technique for DR classification and features extraction. The proposed GWO-ELM is evaluated based on two different datasets, namely APTOS-2019 and Indian Diabetic Retinopathy Image Dataset (IDRiD), in both binary and multi-class classification. The experiment results have shown an excellent performance of the proposed GWO-ELM model where it achieved an accuracy of 96.21% for multi-class and 99.47% for binary using APTOS-2019 dataset as well as 96.15% for multi-class and 99.04% for binary using IDRiD dataset. This demonstrates that the combination of the GWO-ELM and HOG-PCA is an effective classifier for detecting DR and might be applicable in solving other image data types.

Grayscale image statistics of COVID‐19 patient CT scans characterize lung condition with machine and deep learning

Background

Grayscale image attributes of computed tomography (CT) of pulmonary scans contain valuable information relating to patients with respiratory ailments. These attributes are used to evaluate the severity of lung conditions of patients confirmed to be with and without COVID‐19.

Method

Five hundred thirteen CT images relating to 57 patients (49 with COVID‐19; 8 free of COVID‐19) were collected at Namazi Medical Centre (Shiraz, Iran) in 2020 and 2021. Five visual scores (VS: 0, 1, 2, 3, or 4) are clinically assigned to these images with the score increasing with the severity of COVID‐19‐related lung conditions. Eleven deep learning and machine learning techniques (DL/ML) are used to distinguish the VS class based on 12 grayscale image attributes.

Results

The convolutional neural network achieves 96.49% VS accuracy (18 errors from 513 images) successfully distinguishing VS Classes 0 and 1, outperforming clinicians’ visual inspections. An algorithmic score (AS), involving just five grayscale image attributes, is developed independently of clinicians’ assessments (99.81% AS accuracy; 1 error from 513 images).

Conclusion

Grayscale CT image attributes can be successfully used to distinguish the severity of COVID‐19 lung damage. The AS technique developed provides a suitable basis for an automated system using ML/DL methods and 12 image attributes.

Grayscale image statistics of CT scans can effectively classify lung abnormalities

Graphical trends of grayscale statistics distinguish visual assessments COVID‐19 classes

Machine/deep learning algorithms predict severity from image grayscale attributes

Algorithmic class systems can be established using just five grayscale attributes

Confusion matrices provide detailed insight to algorithm prediction capabilities

Metaheuristics based COVID-19 detection using medical images: A review

Many countries in the world have been facing the rapid spread of COVID-19 since February 2020. There is a dire need for efficient and cheap automated diagnosis systems that can reduce the pressure on healthcare systems. Extensive research is being done on the use of image classification for the detection of COVID-19 through X-ray and CT-scan images of patients. Deep learning has been the most popular technique for image classification during the last decade. However, the performance of deep learning-based methods heavily depends on the architecture of the deep neural network. Over the last few years, metaheuristics have gained popularity for optimizing the architecture of deep neural networks. Metaheuristics have been widely used to solve different complex non-linear optimization problems due to their flexibility, simplicity, and problem independence. This paper aims to study the different image classification techniques for chest images, including the applications of metaheuristics for optimization and feature selection of deep learning and machine learning models. The motivation of this study is to focus on applications of different types of metaheuristics for COVID-19 detection and to shed some light on future challenges in COVID-19 detection from medical images. The aim is to inspire researchers to focus their research on overlooked aspects of COVID-19 detection.

An empowered AdaBoost algorithm implementation: A COVID-19 dataset study

The Covid-19 outbreak, which emerged in 2020, became the top priority of the world. The fight against this disease, which has caused millions of people's deaths, is still ongoing, and it is expected that these studies will continue for years. In this study, we propose an improved learning model to predict the severity of the patients by exploiting a combination of machine learning techniques. The proposed model uses an adaptive boost algorithm with a decision tree estimator and a new parameter tuning process. The learning ratio of the new model is promising after many repeated experiments are performed by using different parameters to reduce the effect of selecting random parameters. The proposed algorithm is compared with other recent state-of-the-art algorithms on UCI data sets and a recent Covid-19 dataset. It is observed that competitive accuracy results are obtained, and we hope that this study unveils more usage of advanced machine learning approaches.

X-Ray Equipped with Artificial Intelligence: Changing the COVID-19 Diagnostic Paradigm during the Pandemic

PURPOSE

Due to the excessive use of raw materials in diagnostic tools and equipment during the COVID-19 pandemic, there is a dire need for cheaper and more effective methods in the healthcare system. With the development of artificial intelligence (AI) methods in medical sciences as low-cost and safer diagnostic methods, researchers have turned their attention to the use of imaging tools with AI that have fewer complications for patients and reduce the consumption of healthcare resources. Despite its limitations, X-ray is suggested as the first-line diagnostic modality for detecting and screening COVID-19 cases.

METHOD

This systematic review assessed the current state of AI applications and the performance of algorithms in X-ray image analysis. The search strategy yielded 322 results from four databases and google scholar, 60 of which met the inclusion criteria. The performance statistics included the area under the receiver operating characteristics (AUC) curve, accuracy, sensitivity, and specificity.

RESULT

The average sensitivity and specificity of CXR equipped with AI algorithms for COVID-19 diagnosis were >96% (83%-100%) and 92% (80%-100%), respectively. For common X-ray methods in COVID-19 detection, these values were 0.56 (95% CI 0.51-0.60) and 0.60 (95% CI 0.54-0.65), respectively. AI has substantially improved the diagnostic performance of X-rays in COVID-19.

CONCLUSION

X-rays equipped with AI can serve as a tool to screen the cases requiring CT scans. The use of this tool does not waste time or impose extra costs, has minimal complications, and can thus decrease or remove unnecessary CT slices and other healthcare resources.

Imaging diagnosis of bronchogenic carcinoma (the forgotten disease) during times of COVID-19 pandemic: Current and future perspectives

Patients with bronchogenic carcinoma comprise a high-risk group for coronavirus disease 2019 (COVID-19), pneumonia and related complications. Symptoms of COVID-19 related pulmonary syndrome may be similar to deteriorating symptoms encountered during bronchogenic carcinoma progression. These resemblances add further complexity for imaging assessment of bronchogenic carcinoma. Similarities between clinical and imaging findings can pose a major challenge to clinicians in distinguishing COVID-19 super-infection from evolving bronchogenic carcinoma, as the above-mentioned entities require very different therapeutic approaches. However, the goal of bronchogenic carcinoma management during the pandemic is to minimize the risk of exposing patients to COVID-19, whilst still managing all life-threatening events related to bronchogenic carcinoma. The current pandemic has forced all healthcare stakeholders to prioritize per value resources and reorganize therapeutic strategies for timely management of patients with COVID-19 related pulmonary syndrome. Processing of radiographic and computed tomography images by means of artificial intelligence techniques can facilitate triage of patients. Modified and newer therapeutic strategies for patients with bronchogenic carcinoma have been adopted by oncologists around the world for providing uncompromised care within the accepted standards and new guidelines.

Is minor surgery safe during the COVID-19 pandemic? A multi-disciplinary study

BACKGROUND

To assess the risk of postoperative SARS-CoV-2 infection during the COVID-19 pandemic.

METHODS

The CONCEPTION study was a cohort, multidisciplinary study conducted at Conception University Hospital, in France, from March 17th to May 11th, 2020. Our study included all adult patients who underwent minor surgery in one of the seven surgical departments of our hospital: urology, digestive, plastic, gynecological, otolaryngology, gynecology or maxillofacial surgery. Preoperative self-isolation, clinical assessment using a standardized questionnaire, physical examination, nasopharyngeal RT-PCR and chest CT scan performed the day before surgery were part of our active prevention strategy. The main outcome was the occurrence of a SARS-CoV-2 infection within 21 days following surgery. The COVID-19 status of patients after discharge was updated during the postoperative consultation and to ensure the accuracy of data, all patients were contacted again by telephone.

RESULTS

A total of 551 patients from six different specialized surgical Departments in our tertiary care center were enrolled in our study. More than 99% (546/551) of included patients underwent a complete preoperative Covid-19 screening including RT-PCR testing and chest CT scan upon admission to the Hospital. All RT-PCR tests were negative and in 12 cases (2.2%), preoperative chest CT scans detected pulmonary lesions consistent with the diagnosis criteria for COVID-19. No scheduled surgery was postponed. One patient (0.2%) developed a SARS-CoV-2 infection 20 days after a renal transplantation. No readmission or COVID-19 -related death within 30 days from surgery was recorded.

CONCLUSIONS

Minor surgery remained safe in the COVID-19 Era, as long as all appropriate protective measures were implemented. These data could be useful to public Health Authorities in order to improve surgical patient flow during a pandemic.