Zhou Yang, Feng Jinhua, Mei Shuya, Tang Ri, Xing Shunpeng, Qin Shaojie, Zhang Zhiyun, Xu Qiaoyi, Gao Yuan, He Zhengyu
Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Front Med (Lausanne). 2023 Jul 25;10:1221711. doi: 10.3389/fmed.2023.1221711. eCollection 2023.
The coronavirus disease 2019 (COVID-19) is an acute infectious pneumonia caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection previously unknown to humans. However, predictive studies of acute respiratory distress syndrome (ARDS) in patients with COVID-19 are limited. In this study, we attempted to establish predictive models to predict ARDS caused by COVID-19 via a thorough analysis of patients' clinical data and CT images.
The data of included patients were retrospectively collected from the intensive care unit in our hospital from April 2022 to June 2022. The primary outcome was the development of ARDS after ICU admission. We first established two individual predictive models based on extreme gradient boosting (XGBoost) and convolutional neural network (CNN), respectively; then, an integrated model was developed by combining the two individual models. The performance of all the predictive models was evaluated using the area under receiver operating characteristic curve (AUC), confusion matrix, and calibration plot.
A total of 103 critically ill COVID-19 patients were included in this research, of which 23 patients (22.3%) developed ARDS after admission; five predictive variables were selected and further used to establish the machine learning models, and the XGBoost model yielded the most accurate predictions with the highest AUC (0.94, 95% CI: 0.91-0.96). The AUC of the CT-based convolutional neural network predictive model and the integrated model was 0.96 (95% CI: 0.93-0.98) and 0.97 (95% CI: 0.95-0.99), respectively.
An integrated deep learning model could be used to predict COVID-19 ARDS in critically ill patients.
2019冠状病毒病(COVID-19)是一种由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染引起的急性感染性肺炎,此前人类对该病毒并不知晓。然而,针对COVID-19患者急性呼吸窘迫综合征(ARDS)的预测研究有限。在本研究中,我们试图通过对患者临床数据和CT图像的全面分析,建立预测模型以预测由COVID-19引起的ARDS。
纳入患者的数据于2022年4月至2022年6月从我院重症监护病房回顾性收集。主要结局是入住ICU后发生ARDS。我们首先分别基于极端梯度提升(XGBoost)和卷积神经网络(CNN)建立了两个个体预测模型;然后,通过将两个个体模型相结合开发了一个综合模型。使用受试者操作特征曲线下面积(AUC)、混淆矩阵和校准图评估所有预测模型的性能。
本研究共纳入103例重症COVID-19患者,其中23例(22.3%)入院后发生ARDS;选择了5个预测变量并进一步用于建立机器学习模型,XGBoost模型的预测最为准确,AUC最高(0.94,95%CI:0.91-0.96)。基于CT的卷积神经网络预测模型和综合模型的AUC分别为0.96(95%CI:0.93-0.98)和0.97(95%CI:0.95-0.99)。
综合深度学习模型可用于预测重症患者的COVID-19 ARDS。