Coronavirus Disease 2019 Chest Research Articles

The Relationship Between Pulmonary Artery Diameter Measured by Chest CT and D-Dimer in COVID-19 Patients Admitted to the Emergency Department

Aim: The coronavirus disease 2019 (COVID-19) pandemic has become a global health emergency due to its rapid spread worldwide. Our study evaluated the relationship between pulmonary artery diameter and d-dimer in COVID-19 patients. 
 
 Material and Methods: Patients aged 18 years and older with International Classification of Diseases 10 diagnosis code U07.3 who were admitted to our emergency department between March 15, 2020, and November 31, 2020, were included in our study. Demographic data (age, sex), laboratory tests (polymerase chain reaction test, d-dimer level), and imaging results (chest computed tomography, computed tomography pulmonary angiography) of the patients were retrospectively analyzed using medical records and the hospital electronic record system. 
 
 Results: A total of 1654 patients were included in the study. The 30-day mortality rate was 13.7% (n=227). The most effective independent variable on 30-day mortality was 44 years of age or older. Pulmonary artery diameter and d-dimer levels were found to be higher in both the group with typical COVID-19 chest computed tomography findings and in patients who died within 30 days. However, unlike the literature, there was no significant difference in pulmonary artery diameter and d-dimer levels between patients with and without pulmonary embolism. 
 
 Conclusion: In conclusion, we found a weak positive correlation between d-dimer and pulmonary artery diameter in COVID-19 patients.

COVID-19 Chest Manifestation on CT Scan and Associated Risk Factors for Developing Pulmonary Fibrosis.

This retrospective study describes the imaging findings on chest computed tomography (CT) scans of coronavirus disease 2019 (COVID-19) patients as well as the prevalence of pulmonary fibrosis and the potential risk factors for the disease. One of the major COVID-19 centers in the western province of Saudi Arabia,the King Abdullah Medical Complex in Jeddah, was the site of this study. All adult COVID-19 patients who got a CT chest scan between January 2020 and April 2022 were included in the trial. The imaging findings and pulmonary severity scores (PSS) were obtained from the patients' CT chest. Patients were divided into two groups according to the evidence of fibrotic-like lung changes; clinical and radiological data between the two groups were subsequently compared. Data from the patients' electronic records was collected. The average patient age was 56.4 years, and most (73.5%) patients were men. Two-thirds of the patients had comorbidities (69.1%). CT scans revealed that diffuse lung infiltration is reported in 61% of cases, followed by lower lobes in 19.9%. Ground glass opacity (94.1%), consolidation (76.5%), septal thickening, and/or reticulation (24.4%) were the main chest findings during the initial CT scan. Fibrotic-like lung changes were developed in 9.6% of patients. Patients known to have a positive history of hypertension (p-value = 0.031) and coronary artery disease (CAD) (p-value = 0.011) were found to be significantly more likely to develop lung fibrosis. The patients' pneumonia severity score was significantly higher among the lung fibrotic patients (p-value = 0.026). Also, patients who were diagnosed with pulmonary fibrosis stayed longer in the hospital (p-value 0.001). Sex and age did not correlate significantly with risk of lung fibrosis. Pulmonary fibrosis was observed in 9.6% of COVID-19 patients. A close follow-up of patients with severe pneumonia, prolonged hospitalization, and pre-existing CAD and hypertension was necessary, as pulmonary fibrosis was more likely to occur as a result of these factors. There is a need for a thorough, long-term investigation with a large sample size.

Diagnostic Performance of the Radiological Society of North America Consensus Statement for Reporting COVID-19 Chest CT Findings: A Revisit.

Coronavirus disease 2019 (COVID-19) is a highly contagious respiratory disease that leads to variable degrees of illness, and which may be fatal. We evaluated the diagnostic performance of each chest computed tomography (CT) reporting category recommended by the Expert Consensus of the Radiological Society of North America (RSNA) in comparison with that of reverse transcription polymerase chain reaction (RT-PCR). We aimed to add an analysis of this form of reporting in the Middle East, as few studies have been performed there. Between July 2021 and February 2022, 184 patients with a mean age of 55.56 ± 16.71 years and probable COVID-19 infections were included in this retrospective study. Approximately 64.67% (119 patients) were male, while 35.33% (65 patients) were female. Within 7 days, all patients underwent CT and RT-PCR examinations. According to a statement by the RSNA, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of each CT reporting category were calculated, and the RT-PCR results were used as a standard reference. The RT-PCR results confirmed a final diagnosis of COVID-19 infection in 60.33% of the patients. For COVID-19 diagnoses, the typical category (n = 88) had a sensitivity, specificity, PPV, and accuracy of 74.8%, 93.2%, 94.3%, and 92.5%, respectively. For non-COVID-19 diagnoses, the PPVs for the atypical (n = 22) and negative (n = 46) categories were 81.8% and 89.1%, respectively. The PPV for the indeterminate (n = 28) category was 67.9%, with a low sensitivity of 17.1%. However, the RSNA's four chest CT reporting categories provide a strong diagnostic foundation and are highly correlated with the RT-PCR results for the typical, atypical, and negative categories, but they are weaker for the indeterminate category.

A pipeline to further enhance quality, integrity and reusability of the NCCID clinical data

The National COVID-19 Chest Imaging Database (NCCID) is a centralized UK database of thoracic imaging and corresponding clinical data. It is made available by the National Health Service Artificial Intelligence (NHS AI) Lab to support the development of machine learning tools focused on Coronavirus Disease 2019 (COVID-19). A bespoke cleaning pipeline for NCCID, developed by the NHSx, was introduced in 2021. We present an extension to the original cleaning pipeline for the clinical data of the database. It has been adjusted to correct additional systematic inconsistencies in the raw data such as patient sex, oxygen levels and date values. The most important changes will be discussed in this paper, whilst the code and further explanations are made publicly available on GitLab. The suggested cleaning will allow global users to work with more consistent data for the development of machine learning tools without being an expert. In addition, it highlights some of the challenges when working with clinical multi-center data and includes recommendations for similar future initiatives.

Deep learning attention-guided radiomics for COVID-19 chest radiograph classification.

Accurate assessment of coronavirus disease 2019 (COVID-19) lung involvement through chest radiograph plays an important role in effective management of the infection. This study aims to develop a two-step feature merging method to integrate image features from deep learning and radiomics to differentiate COVID-19, non-COVID-19 pneumonia and normal chest radiographs (CXR). In this study, a deformable convolutional neural network (deformable CNN) was developed and used as a feature extractor to obtain 1,024-dimensional deep learning latent representation (DLR) features. Then 1,069-dimensional radiomics features were extracted from the region of interest (ROI) guided by deformable CNN's attention. The two feature sets were concatenated to generate a merged feature set for classification. For comparative experiments, the same process has been applied to the DLR-only feature set for verifying the effectiveness of feature concatenation. Using the merged feature set resulted in an overall average accuracy of 91.0% for three-class classification, representing a statistically significant improvement of 0.6% compared to the DLR-only classification. The recall and precision of classification into the COVID-19 class were 0.926 and 0.976, respectively. The feature merging method was shown to significantly improve the classification performance as compared to using only deep learning features, regardless of choice of classifier (P value <0.0001). Three classes' F1-score were 0.892, 0.890, and 0.950 correspondingly (i.e., normal, non-COVID-19 pneumonia, COVID-19). A two-step COVID-19 classification framework integrating information from both DLR and radiomics features (guided by deep learning attention mechanism) has been developed. The proposed feature merging method has been shown to improve the performance of chest radiograph classification as compared to the case of using only deep learning features.

COVID-19 Severity based on Deep Convolutional Neural Networks Chest X-Ray Image in Aceh, Indonesia

Introduction: Every area of our lives has been devastated by the worldwide Coronavirus disease 2019 (COVID-19) epidemic. However, the development of artificial intelligence has made it possible to build advanced applications that can fulfill this level of clinical accuracy. This study aimed to create a deep learning model that can detect COVID-19 from a chest image dataset of confirmed patients treated at the provincial hospital in Aceh. Methods: Eight hundred confirmed COVID-19 patients' chest X-ray photos were gathered locally from Dr. Zainoel Abidin General Hospital, Banda Aceh. Performance was evaluated in several ways. First, the dataset was used for training and testing. Second, the data was used to train and test the model. VGG16 is a robust network adapted to an enhanced dataset constructed from a confirmed COVID-19 chest X-ray pool. To artificially produce a huge number of chest X-ray pictures, this study used data augmentation techniques such as random rotation at an angle between 10 and 10°, random noise, and horizontal flips. Results: The experimental results were encouraging: the proposed models classified chest X-ray pictures as normal or COVID-19 with an accuracy of 97.20% for Resnet50, 98.10% for InceptionV3, and 98.30% for VGG16. The results showed the outstanding performance of straightforward COVID-19 diagnosis with the classification of COVID-19 severity, such as mild, severe, and very severe. Conclusion: These made it possible to automate the X-ray image interpretation process accurately and could also be applied when materials and reverse transcription polymerase chain reaction (RT-PCR) tests are scarce.

Uncertain-CAM: Uncertainty-Based Ensemble Machine Voting for Improved COVID-19 CXR Classification and Explainability.

The ongoing coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on patients and healthcare systems across the world. Distinguishing non-COVID-19 patients from COVID-19 patients at the lowest possible cost and in the earliest stages of the disease is a major issue. Additionally, the implementation of explainable deep learning decisions is another issue, especially in critical fields such as medicine. The study presents a method to train deep learning models and apply an uncertainty-based ensemble voting policy to achieve 99% accuracy in classifying COVID-19 chest X-rays from normal and pneumonia-related infections. We further present a training scheme that integrates the cyclic cosine annealing approach with cross-validation and uncertainty quantification that is measured using prediction interval coverage probability (PICP) as final ensemble voting weights. We also propose the Uncertain-CAM technique, which improves deep learning explainability and provides a more reliable COVID-19 classification system. We introduce a new image processing technique to measure the explainability based on ground-truth, and we compared it with the widely adopted Grad-CAM method.

DMFL_Net: A Federated Learning-Based Framework for the Classification of COVID-19 from Multiple Chest Diseases Using X-rays.

Coronavirus Disease 2019 (COVID-19) is still a threat to global health and safety, and it is anticipated that deep learning (DL) will be the most effective way of detecting COVID-19 and other chest diseases such as lung cancer (LC), tuberculosis (TB), pneumothorax (PneuTh), and pneumonia (Pneu). However, data sharing across hospitals is hampered by patients' right to privacy, leading to unexpected results from deep neural network (DNN) models. Federated learning (FL) is a game-changing concept since it allows clients to train models together without sharing their source data with anybody else. Few studies, however, focus on improving the model's accuracy and stability, whereas most existing FL-based COVID-19 detection techniques aim to maximize secondary objectives such as latency, energy usage, and privacy. In this work, we design a novel model named decision-making-based federated learning network (DMFL_Net) for medical diagnostic image analysis to distinguish COVID-19 from four distinct chest disorders including LC, TB, PneuTh, and Pneu. The DMFL_Net model that has been suggested gathers data from a variety of hospitals, constructs the model using the DenseNet-169, and produces accurate predictions from information that is kept secure and only released to authorized individuals. Extensive experiments were carried out with chest X-rays (CXR), and the performance of the proposed model was compared with two transfer learning (TL) models, i.e., VGG-19 and VGG-16 in terms of accuracy (ACC), precision (PRE), recall (REC), specificity (SPF), and F1-measure. Additionally, the DMFL_Net model is also compared with the default FL configurations. The proposed DMFL_Net + DenseNet-169 model achieves an accuracy of 98.45% and outperforms other approaches in classifying COVID-19 from four chest diseases and successfully protects the privacy of the data among diverse clients.

COVID-19 chest X-ray image classification in the presence of noisy labels

The Corona Virus Disease 2019 (COVID-19) has been declared a worldwide pandemic, and a key method for diagnosing COVID-19 is chest X-ray imaging. The application of convolutional neural network with medical imaging helps to diagnose the disease accurately, where the label quality plays an important role in the classification problem of COVID-19 chest X-rays. However, most of the existing classification methods ignore the problem that the labels are hardly completely true and effective, and noisy labels lead to a significant degradation in the performance of image classification frameworks. In addition, due to the wide distribution of lesions and the large number of local features of COVID-19 chest X-ray images, existing label recovery algorithms have to face the bottleneck problem of the difficult reuse of noisy samples. Therefore, this paper introduces a general classification framework for COVID-19 chest X-ray images with noisy labels and proposes a noisy label recovery algorithm based on subset label iterative propagation and replacement (SLIPR). Specifically, the proposed algorithm first obtains random subsets of the samples multiple times. Then, it integrates several techniques such as principal component analysis, low-rank representation, neighborhood graph regularization, and k-nearest neighbor for feature extraction and image classification. Finally, multi-level weight distribution and replacement are performed on the labels to cleanse the noise. In addition, for the label-recovered dataset, high confidence samples are further selected as the training set to improve the stability and accuracy of the classification framework without affecting its inherent performance. In this paper, three typical datasets are chosen to conduct extensive experiments and comparisons of existing algorithms under different metrics. Experimental results on three publicly available COVID-19 chest X-ray image datasets show that the proposed algorithm can effectively recover noisy labels and improve the accuracy of the image classification framework by 18.9% on the Tawsifur dataset, 19.92% on the Skytells dataset, and 16.72% on the CXRs dataset. Compared to the state-of-the-art algorithms, the gain of classification accuracy of SLIPR on the three datasets can reach 8.67%-19.38%, and the proposed algorithm also has certain scalability while ensuring data integrity.

Multi-verse Optimizer with Rosenbrock and Diffusion Mechanisms for Multilevel Threshold Image Segmentation from COVID-19 Chest X-Ray Images.

Coronavirus Disease 2019 (COVID-19) is the most severe epidemic that is prevalent all over the world. How quickly and accurately identifying COVID-19 is of great significance to controlling the spread speed of the epidemic. Moreover, it is essential to accurately and rapidly identify COVID-19 lesions by analyzing Chest X-ray images. As we all know, image segmentation is a critical stage in image processing and analysis. To achieve better image segmentation results, this paper proposes to improve the multi-verse optimizer algorithm using the Rosenbrock method and diffusion mechanism named RDMVO. Then utilizes RDMVO to calculate the maximum Kapur's entropy for multilevel threshold image segmentation. This image segmentation scheme is called RDMVO-MIS. We ran two sets of experiments to test the performance of RDMVO and RDMVO-MIS. First, RDMVO was compared with other excellent peers on IEEE CEC2017 to test the performance of RDMVO on benchmark functions. Second, the image segmentation experiment was carried out using RDMVO-MIS, and some meta-heuristic algorithms were selected as comparisons. The test image dataset includes Berkeley images and COVID-19 Chest X-ray images. The experimental results verify that RDMVO is highly competitive in benchmark functions and image segmentation experiments compared with other meta-heuristic algorithms.

Deep Transfer Learning for COVID-19 Detection and Lesion Recognition Using Chest CT Images.

Starting from December 2019, the global pandemic of coronavirus disease 2019 (COVID-19) is continuously expanding and has caused several millions of deaths worldwide. Fast and accurate diagnostic methods for COVID-19 detection play a vital role in containing the plague. Chest computed tomography (CT) is one of the most commonly used diagnosis methods. However, a complete CT-scan has hundreds of slices, and it is time-consuming for radiologists to check each slice to diagnose COVID-19. This study introduces a novel method for fast and automated COVID-19 diagnosis using the chest CT scans. The proposed models are based on the state-of-the-art deep convolutional neural network (CNN) architecture, and a 2D global max pooling (globalMaxPool2D) layer is used to improve the performance. We compare the proposed models to the existing state-of-the-art deep learning models such as CNN based models and vision transformer (ViT) models. Based off of metric such as area under curve (AUC), sensitivity, specificity, accuracy, and false discovery rate (FDR), experimental results show that the proposed models outperform the previous methods, and the best model achieves an area under curve of 0.9744 and accuracy 94.12% on our test datasets. It is also shown that the accuracy is improved by around 1% by using the 2D global max pooling layer. Moreover, a heatmap method to highlight the lesion area on COVID-19 chest CT images is introduced in the paper. This heatmap method is helpful for a radiologist to identify the abnormal pattern of COVID-19 on chest CT images. In addition, we also developed a freely accessible online simulation software for automated COVID-19 detection using CT images. The proposed deep learning models and software tool can be used by radiologist to diagnose COVID-19 more accurately and efficiently.

Prevalence of COVID-19 Among Older People with Type 2 Diabetes Mellitus: A Systematic Review

Background: On March 11, 2020, the WHO proclaimed the Coronavirus Disease 2019 (COVID-19) pandemic owing to coronavirus-2 (SARS-CoV-2). SARS-CoV-2 is a zoonotic virus that may be spread from bats to humans through airborne droplets and aerosols. SARS-CoV-2 spike protein has a high binding affinity for ACE2 receptors, widely expressed throughout the respiratory system, notably in epithelial lung cells. ACE2 receptors are found in intestinal mucosal, endothelial, heart, renal epithelial as well as cerebral neuronal cells, explaining COVID-19 extrapulmonary symptoms like diarrhea, nausea, vomiting, chest pain, heart failure, renal injury, headache, and confusion. Older persons with type2 diabetes mellitus and hypertension are more susceptible to SARS-CoV-2 infection as drugs by which they are treated promote ACE2 receptor expression. Moreover, comorbidities increase the probability of poor outcomes after infection by the SARS-CoV-2. Research links COVID-19 to hyperglycemia in the elderly with type 2 diabetes. Twenty percent of people with diabetes get severe pneumonia and a septic course from viral infections. Diabetes contributed to sickness severity and fatality in MERS (MERS-CoV). Epidemiological findings in SARS-CoV-2-affected regions, CDC data, and other national health centers and hospitals suggest that individuals with diabetes had a 50% greater chance of dying from COVID-19. Methods: This systematic review involves a critical and reproducible summary of the results of the available publications on COVID-19 and diabetic elderly patients’ topics and questions. Fourteen studies (6 retrospective cohorts, two prospective, two cohorts, one combined retrospective, one observational, one cross-sectional, and one hospital-based study) were included in this systematic review. Results: From all studies, the mean age of older adults with type 2 diabetes mellitus who suffered from COVID-19 was 50 to 89 years. The majority of the studies showed the male predominance of infection. The pooled prevalence of COVID-19 among diabetes mellitus elderly patients was 29.8%. Conclusions: Diabetes patients had a greater COVID-19 prevalence and severity, according to several explanations. Diabetes Mellitus increases the risk of infection due to innate and adaptive immunity deficiencies. Post COVID-19 complications arise due to a lack of equilibrium between pro-inflammatory and anti-inflammatory cytokine networks in type 2 diabetes mellitus, contributing to increased mortality. Therefore, this study necessitates a large investigational study to find out how to boost the immune response against SARS-CoV-2 infection in an equilibrium manner not to produce much inflammatory cytokine in type 2 diabetes mellitus individuals to reduce the risk of developing complications and mortality consequently. Keywords: COVID-19, Diabetes mellitus, Type-2 diabetes, Elderly.

Publication timeline of chest imaging reporting in children with coronavirus disease 2019 (COVID-19): a systematic review spanning 2020.

Amid the coronavirus disease 2019 (COVID-19) pandemic, numerous publications of imaging findings in children have surfaced in a very short time. Publications discuss populations of overlapping age groups and describe different imaging patterns. We aim to present an overview of the quantity and type of literature available regarding COVID-19 chest imaging findings in children according to a 2020 publication timeline. We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. We searched terminology related to COVID-19, chest, children and imaging modalities in PubMed and Embase. The included papers were published online in 2020 and described imaging findings specific to children and reported five or more cases. Two researchers reviewed each abstract to determine inclusion or exclusion, and a radiologist reconciled any disagreements. Then we reviewed full articles for the main analysis. Eligible study designs included original articles, case series (≥5 cases), systematic reviews and meta-analyses. We excluded non-English manuscripts, retracted articles, and those without available full text. The remaining articles were distributed to four pediatric radiologists (on the Society for Pediatric Radiology Thoracic Committee), who summarized chest imaging findings. Eighty-two articles were included in the final analysis — 28% in radiology journals and 71% in non-radiology journals; 71% contained original data and 29% were review-style papers. There was a disproportionate contribution of review-style papers in April (55%), considering the paucity of preceding publications with original data in March (5 papers). June had the highest number of publications (n=14), followed by April (n=11) and July (n=11). Most (52%) original papers were from China and most individual pediatric imaging descriptions were from China (57%), while the majority of review papers (83%) were international. Imaging descriptions were available for 2,199 children (1,678 CT descriptions and 780 chest radiography descriptions). Findings included a 25% normal CT scan reports vs. 40% normal chest radiography reports. Ground-glass opacification was the most common CT finding (33%) and was reported in only a minority of chest radiographs (9%). A significant amount of information on pediatric COVID-19 chest imaging has become rapidly available over a short period. Most publications in 2020 were original articles, but they were published more often in non-radiology journals. A disproportionate number of review articles were published early on and were based on little original pediatric imaging data. CT scan reports, which represent the standard, outnumbered radiographic reports and indicated that ground-glass opacification is the main imaging finding and that only a quarter of scans are normal in children with COVID-19.

An Image Importance Partition-Based Compression Method for COVID-19 Computed Tomography Scan

As the coronavirus disease 2019 (COVID-19) spreads around the world, industrial automated medical diagnosis systems have been developed, which complete a large amount of medical diagnosis work through computed tomography (CT) images. In these systems, how to quickly store and transmit such a large amount of CT image information has important research significance. In this article, a more targeted COVID-19 chest CT image codec is proposed to make image data not only occupy less space but also have higher image quality. First, the bilateral lung contours are extracted to calculate the position information of the region of interest (ROI). Then, a CT image is classified into four types of nonuniform image blocks according to the characteristics of COVID-19 chest CT images and ROI position information. Next, a series of new transformations are proposed for more efficient transform coding. Finally, a flexible quantization strategy is proposed for the adaptive quantization part. In the experiments, the proposed method is superior to some of the existing methods with similar computational complexity. At the same bit rate, it significantly improves the image quality. This means that chest CT images can still be used for disease diagnosis while taking up less space. In addition, because of the low computational complexity of the proposed method, it can be more easily embedded into the CT equipment with low computational power.

Case Report of a Critically Ill Patient with COVID-19 in Early Outbreak

Introduction: Corona Virus Disease 2019 (COVID-19) has spread rapidly throughout the world. Many people died of this disease. We reported a case of critical illness with COVID-19 pneumonia that occurred in the early stage of viral spread in China and describe the identification, diagnosis, clinical course, and management of the case, including the patient’s symptoms throughout the course. Patient concerns: This article describes the whole diagnosis and treatment process of a critically ill patient in a case report. Diagnosis: The patient was a physician and presented to a fever clinic with a history of treating a suspected patient without special protection the day before. After 5 days, a nucleic acid test for COVID-19 was positive. Then, the patient was transferred to the intensive care unit (ICU) immediately because of severe dyspnea. He was diagnosed with COVID-19 based on a history of exposure, severe acute respiratory syndrome, positive COVID-19 test and chest computed tomography (CT). Interventions: Various therapies were used in this critically ill patient, including anti-infection drugs, hormones, immunoglobulins, herbal medicine, noninvasive ventilation, and special plasma. Outcomes: The patient recovered completely and was discharged after one month of hospitalization. COVID-19 was tested negative and a chest CT showed marked improvement prior to discharge after 4 weeks admission. Conclusion: This study highlights the complexity of treatment and recurrent positivity of the critically ill COVID-19 pneumonia patient and aims to provide useful reference and information for our knowledge of the clinical spectrum of disease.

MFDNN: multi-channel feature deep neural network algorithm to identify COVID19 chest X-ray images.

The use of chest X-ray images (CXI) to detect Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2) caused by Coronavirus Disease 2019 (COVID19) is life-saving important for both patients and doctors. This research proposes a multi-channel feature deep neural network (MFDNN) algorithm to screen people infected with COVID19. The algorithm integrates data over-sampling technology and MFDNN model to carry out the training. The oversampling technique reduces the deviation of the prior probability of the MFDNN algorithm on unbalanced data. Multi-channel feature fusion technology improves the efficiency of feature extraction and the accuracy of model diagnosis. In the experiment, Compared with traditional deep learning models (VGG19, GoogLeNet, Resnet50, Desnet201), the MFDNN model obtains an average test accuracy of 93.19% in all data. Furthermore, in each type of screening, the precision, recall, and F1 Score of the MFDNN model are also better than traditional deep learning networks. Furthermore, through ablation experiments, we proved that a multi-channel convolutional neural network (CNN) is superior to single-channel CNN, additional layer and PSN module, and indirectly proved the sufficiency and necessity of each step of the MFDNN classification method. Finally, our experimental code will be placed at https://github.com/panliangrui/covid19.

PCXRNet: Pneumonia Diagnosis From Chest X-Ray Images Using Condense Attention Block and Multiconvolution Attention Block.

Coronavirus disease2019 (COVID-19)has become a global pandemic. Many recognition approaches based on convolutional neural networks have been proposed for COVID-19 chest X-ray images. However, only a few of them make good use of the potential inter- and intra-relationships of feature maps. Considering the limitation mentioned above, this paper proposes an attention-based convolutional neural network, called PCXRNet, for diagnosis of pneumonia using chest X-ray images. To utilize the information from the channels of the feature maps, we added a novel condense attention module (CDSE) that comprised of two steps: condensation step and squeeze-excitation step. Unlike traditional channel attention modules, CDSE first downsamples the feature map channel by channel to condense the information, followed by the squeeze-excitation step, in which the channel weights are calculated. To make the model pay more attention to informative spatial parts in every feature map, we proposed a multi-convolution spatial attention module (MCSA). It reduces the number of parameters and introduces more nonlinearity. The CDSE and MCSA complement each other in series to tackle the problem of redundancy in feature maps and provide useful information from and between feature maps. We used the ChestXRay2017 dataset to explore the internal structure of PCXRNet, and the proposed network was applied to COVID-19 diagnosis. As a result, the network achieves an accuracy of 94.619%, recall of 94.753%, precision of 95.286%, and F1-score of 94.996% on the COVID-19 dataset.

Advanced Cognitive Algorithm for Biomedical Data Processing: COVID-19 Pattern Recognition as a Case Study.

Automated disease prediction has now become a key concern in medical research due to exponential population growth. The automated disease identification framework aids physicians in diagnosing disease, which delivers accurate disease prediction that provides rapid outcomes and decreases the mortality rate. The spread of Coronavirus disease 2019 (COVID-19) has a significant effect on public health and the everyday lives of individuals currently residing in more than 100 nations. Despite effective attempts to reach an appropriate trend to forecast COVID-19, the origin and mutation of the virus is a crucial obstacle in the diagnosis of the detected cases. Even so, the development of a model to forecast COVID-19 from chest X-ray (CXR) and computerized tomography (CT) images with the correct decision is critical to assist with intelligent detection. In this paper, a proposed hybrid model of the artificial neural network (ANN) with parameters optimization by the butterfly optimization algorithm has been introduced. The proposed model was compared with the pretrained AlexNet, GoogLeNet, and the SVM to identify the publicly accessible COVID-19 chest X-ray and CT images. There were six datasets for the examinations: three datasets with X-ray pictures and three with CT images. The experimental results approved the superiority of the proposed model for cognitive COVID-19 pattern recognition with average accuracy 90.48, 81.09, 86.76, and 84.97% for the proposed model, support vector machine (SVM), AlexNet, and GoogLeNet, respectively.

Chest X-ray Severity Score as a Putative Predictor of Clinical Outcome in Hospitalized Patients: An Experience From a Vietnamese COVID-19 Field Hospital.

BackgroundThrough the coronavirus disease 2019 (COVID-19) pandemic, portable radiography was particularly useful for assessing and monitoring the COVID-19 disease in Vietnamese field hospitals. It provides a convenient and precise picture of the progression of the disease. The purpose of this study was to evaluate the predictive value of chest radiograph reporting systems (Brixia and total severity score (TSS)) and the National Early Warning Score (NEWS) clinical score in a group of hospitalized patients with COVID-19.MethodsThis retrospective cohort study used routinely collected clinical data from polymerase chain reaction (PCR)-positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients admitted to Field Hospital District 8, Ho Chi Minh City, Vietnam, from August 2021 to September 2021. The initial chest radiographs were scored based on the TSS and Brixia scoring systems to quantify the extent of lung involvement. After the chest radiograph score was reported, two residents calculated the rate of all-cause in-hospital mortality with the consultation of expert radiologists. In this study, NEWS2 scores on hospital admission were calculated. The gradient boosting machines (GBMs) and Shapley additive exPlanations (SHAP) were applied to access the important variable and improve the accuracy of mortality prediction. The adjusted odds ratio for predictor was presented by univariate analysis and multivariate analysis.ResultsThe chest X-rays (CXRs) at the admission of 273 patients (mean age 59 years +/-16, 42.1% were male) were scored. In the univariate analysis, age, vaccination status, previous disease, NEWS2, a saturation of peripheral oxygen (Sp02), the Brixia and TSS scores were significant predictors of mortality (p-value < 0.05). In multivariate analysis, there were statistically significant differences in mortality between age, Sp02, Brixia score, and patients with previous diseases were independent predictors of mortality and hospitalization.A gradient boosting machine was performed in the train data set, which showed that the best hyperparameters for predicting the mortality of patients are the Brixia score (exclude TSS score). In the top five predictors, an increase in Brixia, age, and BMI increased the logarithmic number of probability clarifying as death status. Although the TSS and Brixia scores evaluated chest imaging, the TSS score was not essential as the Brixia score (rank 6/11). It was clear that the BMI and NEWS2 score was positively correlated with the Brixia score, and age did not affect this correlation. Meanwhile, we did not find any trend between the TSS score versus BMI and NEWS2.ConclusionWhen integrated with the BMI and NEWS2 clinical classification systems, the severity score of COVID-19 chest radiographs, particularly the Brixia score, was an excellent predictor of all-cause in-hospital mortality.

Explainable Machine Learning for COVID-19 Pneumonia Classification With Texture-Based Features Extraction in Chest Radiography.

Both reverse transcription-PCR (RT-PCR) and chest X-rays are used for the diagnosis of the coronavirus disease-2019 (COVID-19). However, COVID-19 pneumonia does not have a defined set of radiological findings. Our work aims to investigate radiomic features and classification models to differentiate chest X-ray images of COVID-19-based pneumonia and other types of lung patterns. The goal is to provide grounds for understanding the distinctive COVID-19 radiographic texture features using supervised ensemble machine learning methods based on trees through the interpretable Shapley Additive Explanations (SHAP) approach. We use 2,611 COVID-19 chest X-ray images and 2,611 non-COVID-19 chest X-rays. After segmenting the lung in three zones and laterally, a histogram normalization is applied, and radiomic features are extracted. SHAP recursive feature elimination with cross-validation is used to select features. Hyperparameter optimization of XGBoost and Random Forest ensemble tree models is applied using random search. The best classification model was XGBoost, with an accuracy of 0.82 and a sensitivity of 0.82. The explainable model showed the importance of the middle left and superior right lung zones in classifying COVID-19 pneumonia from other lung patterns.