BIO-CXRNET: A Robust Multimodal Stacking Machine Learning Technique for Mortality Risk Prediction of COVID-19 Patients using Chest X-Ray Images and Clinical Data

Fast and accurate detection of the disease can significantly help in reducing the strain on the healthcare facility of any country to reduce the mortality during any pandemic. The goal of this work is to create a multimodal system using a novel machine learning framework that uses both Chest X-ray (CXR) images and clinical data to predict severity in COVID-19 patients. In addition, the study presents a nomogram-based scoring technique for predicting the likelihood of death in high-risk patients. This study uses 25 biomarkers and CXR images in predicting the risk in 930 COVID-19 patients admitted during the first wave of COVID-19 (March-June 2020) in Italy. The proposed multimodal stacking technique produced the precision, sensitivity, and F1-score, of 89.03%, 90.44%, and 89.03%, respectively to identify low or high-risk patients. This multimodal approach improved the accuracy by 6% in comparison to the CXR image or clinical data alone. Finally, nomogram scoring system using multivariate logistic regression -- was used to stratify the mortality risk among the high-risk patients identified in the first stage. Lactate Dehydrogenase (LDH), O2 percentage, White Blood Cells (WBC) Count, Age, and C-reactive protein (CRP) were identified as useful predictor using random forest feature selection model. Five predictors parameters and a CXR image based nomogram score was developed for quantifying the probability of death and categorizing them into two risk groups: survived (<50%), and death (>=50%), respectively. The multi-modal technique was able to predict the death probability of high-risk patients with an F1 score of 92.88 %. The area under the curves for the development and validation cohorts are 0.981 and 0.939, respectively.

Can AI help in screening Viral and COVID-19 pneumonia?

Coronavirus disease (COVID-19) is a pandemic disease, which has already infected around 3 million people and caused fatalities of above 200 thousand. The aim of this paper is to automatically detect COVID-19 pneumonia patients using digital x-ray images while maximizing the accuracy in detection using image pre-processing and deep-learning techniques. A public database was created by the authors using three public databases and by collecting images from recently published articles. The database contains a mixture of 190 COVID-19, 1345 viral pneumonia, and 1341 normal chest x-ray images. An image augmented training set was created with around 2600 images of each category for training and validating four different pre-trained deep Convolutional Neural Networks (CNNs). These networks were tested for the classification of two different schemes (normal and COVID-19 pneumonia; normal, viral and COVID-19 pneumonia). The classification accuracy, sensitivity, specificity and precision for both the schemes were 98.3%, 96.7%, 100%, 100% and 98.3%, 96.7%, 99%, 100%, respectively. The high accuracy of this computer-aided diagnostic tool can significantly improve the speed and accuracy of diagnosing cases with COVID-19. This would be highly useful in this pandemic where disease burden and need for preventive measures are at odds with available resources.