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用于COVID-19诊断和临床分类的人工智能系统

Artificial Intelligence Systems for Diagnosis and Clinical Classification of COVID-19.

作者信息

Yu Lan, Shi Xiaoli, Liu Xiaoling, Jin Wen, Jia Xiaoqing, Xi Shuxue, Wang Ailan, Li Tianbao, Zhang Xiao, Tian Geng, Sun Dejun

机构信息

Clinical Medical Research Center/Inner Mongolia Key Laboratory of Gene Regulation of the Metabolic Diseases, Inner Mongolia People's Hospital, Hohhot, China.

Department of Endocrinology, Inner Mongolia People's Hospital, Hohhot, China.

出版信息

Front Microbiol. 2021 Sep 27;12:729455. doi: 10.3389/fmicb.2021.729455. eCollection 2021.

Abstract

COVID-19 is highly infectious and has been widely spread worldwide, with more than 159 million confirmed cases and more than 3 million deaths as of May 11, 2021. It has become a serious public health event threatening people's lives and safety. Due to the rapid transmission and long incubation period, shortage of medical resources would easily occur in the short term of discovering disease cases. Therefore, we aimed to construct an artificial intelligent framework to rapidly distinguish patients with COVID-19 from common pneumonia and non-pneumonia populations based on computed tomography (CT) images. Furthermore, we explored artificial intelligence (AI) algorithms to integrate CT features and laboratory findings on admission to predict the clinical classification of COVID-19. This will ease the burden of doctors in this emergency period and aid them to perform timely and appropriate treatment on patients. We collected all CT images and clinical data of novel coronavirus pneumonia cases in Inner Mongolia, including domestic cases and those imported from abroad; then, three models based on transfer learning to distinguish COVID-19 from other pneumonia and non-pneumonia population were developed. In addition, CT features and laboratory findings on admission were combined to predict clinical types of COVID-19 using AI algorithms. Lastly, Spearman's correlation test was applied to study correlations of CT characteristics and laboratory findings. Among three models to distinguish COVID-19 based on CT, vgg19 showed excellent diagnostic performance, with area under the curve (AUC) of the receiver operating characteristic (ROC) curve at 95%. Together with laboratory findings, we were able to predict clinical types of COVID-19 with AUC of the ROC curve at 90%. Furthermore, biochemical markers, such as C-reactive protein (CRP), LYM, and lactic dehydrogenase (LDH) were identified and correlated with CT features. We developed an AI model to identify patients who were positive for COVID-19 according to the results of the first CT examination after admission and predict the progression combined with laboratory findings. In addition, we obtained important clinical characteristics that correlated with the CT image features. Together, our AI system could rapidly diagnose COVID-19 and predict clinical types to assist clinicians perform appropriate clinical management.

摘要

新型冠状病毒肺炎(COVID-19)具有高度传染性,已在全球广泛传播,截至2021年5月11日,确诊病例超过1.59亿例,死亡人数超过300万。它已成为威胁人们生命安全的严重公共卫生事件。由于其传播迅速且潜伏期长,在发现病例的短期内很容易出现医疗资源短缺的情况。因此,我们旨在构建一个人工智能框架,基于计算机断层扫描(CT)图像快速将COVID-19患者与普通肺炎患者及非肺炎人群区分开来。此外,我们探索了人工智能(AI)算法,以整合入院时的CT特征和实验室检查结果,来预测COVID-19的临床分类。这将在这个紧急时期减轻医生的负担,并帮助他们对患者进行及时、恰当的治疗。我们收集了内蒙古新型冠状病毒肺炎病例的所有CT图像和临床数据,包括本土病例和境外输入病例;然后,开发了三种基于迁移学习的模型,用于将COVID-19与其他肺炎及非肺炎人群区分开来。此外,利用AI算法将入院时的CT特征和实验室检查结果相结合,以预测COVID-19的临床类型。最后,应用Spearman相关性检验来研究CT特征与实验室检查结果之间的相关性。在基于CT区分COVID-19的三种模型中,vgg19显示出优异的诊断性能,其受试者操作特征(ROC)曲线下面积(AUC)为95%。结合实验室检查结果,我们能够以ROC曲线AUC为90%来预测COVID-19的临床类型。此外,还确定了一些生化标志物,如C反应蛋白(CRP)、淋巴细胞(LYM)和乳酸脱氢酶(LDH),并将它们与CT特征相关联。我们开发了一个AI模型,根据入院后首次CT检查结果识别COVID-19阳性患者,并结合实验室检查结果预测病情进展。此外,我们获得了与CT图像特征相关的重要临床特征。总之,我们的AI系统可以快速诊断COVID-19并预测临床类型,以协助临床医生进行适当的临床管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b97e/8507494/1a6b32297ee4/fmicb-12-729455-g001.jpg

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