Prognosis of COVID-19 using Artificial Intelligence: A Systematic Review and Meta-analysis
Abstract
Purpose: Artificial intelligence (AI) techniques have been extensively utilized for diagnosing and prognosis of several diseases in recent years. This study identifies, appraises and synthesizes published studies on the use of AI for the prognosis of COVID-19.
Method: Electronic search was performed using Medline, Google Scholar, Scopus, Embase, Cochrane and ProQuest. Studies that examined machine learning or deep learning methods to determine the prognosis of COVID-19 using CT or chest X-ray images were included. Polled sensitivity, specificity area under the curve and diagnostic odds ratio were calculated.
Result: A total of 36 articles were included; various prognosis-related issues, including disease severity, mechanical ventilation or admission to the intensive care unit and mortality, were investigated. Several AI models and architectures were employed, such as the Siamense model, support vector machine, Random Forest , eXtreme Gradient Boosting, and convolutional neural networks. The models achieved 71%, 88% and 67% sensitivity for mortality, severity assessment and need for ventilation, respectively. The specificity of 69%, 89% and 89% were reported for the aforementioned variables.
Conclusion: Based on the included articles, machine learning and deep learning methods used for the prognosis of COVID-19 patients using radiomic features from CT or CXR images can help clinicians manage patients and allocate resources more effectively. These studies also demonstrate that combining patient demographic, clinical data, laboratory tests and radiomic features improves model performances.
2- Hiba Abdelsadig Mohammed, Shahd Abubaker Elamin, Alla El-Awaisi, and Maguy Saffouh El Hajj, "Use of the job demands-resource model to understand community pharmacists’ burnout during the COVID-19 pandemic." Research in Social and Administrative Pharmacy, (2022).
3- L. Wynants et al., "Prediction models for diagnosis and prognosis of covid-19: systematic review and critical appraisal." (in eng), Bmj, Vol. 369p. m1328, Apr 7 (2020).
4- F. Abdulla, Z. Nain, M. Karimuzzaman, M. M. Hossain, and A. Rahman, "A Non-Linear Biostatistical Graphical Modeling of Preventive Actions and Healthcare Factors in Controlling COVID-19 Pandemic." (in eng), Int J Environ Res Public Health, Vol. 18 (No. 9), Apr 23 (2021).
5- Y. Bouchareb et al., "Artificial intelligence-driven assessment of radiological images for COVID-19." (in eng), Comput Biol Med, Vol. 136p. 104665, Sep (2021).
6- Buddhisha Udugama et al., "Diagnosing COVID-19: the disease and tools for detection." ACS nano, Vol. 14 (No. 4), pp. 3822-35, (2020).
7- Wei-jie Guan et al., "Clinical characteristics of coronavirus disease 2019 in China." New England journal of medicine, Vol. 382 (No. 18), pp. 1708-20, (2020).
8- A. Kohli, T. Jha, and A. B. Pazhayattil, "The value of AI based CT severity scoring system in triage of patients with Covid-19 pneumonia as regards oxygen requirement and place of admission." (in English), Indian Journal of Radiology and Imaging, Article Vol. 31 (No. 5), pp. S61-S69, (2021).
9- Qin Sun, Haibo Qiu, Mao Huang, and Yi Yang, "Lower mortality of COVID-19 by early recognition and intervention: experience from Jiangsu Province." Annals of intensive care, Vol. 10 (No. 1), pp. 1-4, (2020).
10- Pavel Hamet and Johanne Tremblay, "Artificial intelligence in medicine." Metabolism, Vol. 69pp. S36-S40, (2017).
11- Hossein Mohammad-Rahimi, Mohadeseh Nadimi, Azadeh Ghalyanchi-Langeroudi, Mohammad Taheri, and Soudeh Ghafouri-Fard, "Application of machine learning in diagnosis of COVID-19 through X-ray and CT images: a scoping review." Frontiers in cardiovascular medicine, Vol. 8p. 638011, (2021).
12- T. J. Bradshaw et al., "Nuclear Medicine and Artificial Intelligence: Best Practices for Algorithm Development." (in eng), J Nucl Med, Vol. 63 (No. 4), pp. 500-10, Apr (2022).
13- Chen Ma, Zhihao Yao, Qinran Zhang, and Xiufen Zou, "Quantitative integration of radiomic and genomic data improves survival prediction of low-grade glioma patients." Mathematical Biosciences and Engineering, Vol. 18 (No. 1), pp. 727-44, (2021).
14- Hossein Mohammad-Rahimi et al., "Deep Learning for Caries Detection: A Systematic Review: DL for Caries Detection." Journal of Dentistry, p. 104115, (2022).
15- Hossein Mohammad‐Rahimi et al., "Deep learning in periodontology and oral implantology: A scoping review." Journal of Periodontal Research, (2022).
16- Hossein Mohammad-Rahimi, Mohadeseh Nadimi, Mohammad Hossein Rohban, Erfan Shamsoddin, Victor Y Lee, and Saeed Reza Motamedian, "Machine learning and orthodontics, current trends and the future opportunities: a scoping review." American Journal of Orthodontics and Dentofacial Orthopedics, Vol. 160 (No. 2), pp. 170-92. e4, (2021).
17- Ș Busnatu et al., "Clinical Applications of Artificial Intelligence-An Updated Overview." (in eng), J Clin Med, Vol. 11 (No. 8), Apr 18 (2022).
18- I. Buvat and F. Orlhac, "The T.R.U.E. Checklist for Identifying Impactful Artificial Intelligence-Based Findings in Nuclear Medicine: Is It True? Is It Reproducible? Is It Useful? Is It Explainable?" (in eng), J Nucl Med, Vol. 62 (No. 6), pp. 752-54, Jun 1 (2021).
19- Michael Roberts et al., "Common pitfalls and recommendations for using machine learning to detect and prognosticate for COVID-19 using chest radiographs and CT scans." Nature Machine Intelligence, Vol. 3 (No. 3), pp. 199-217, 2021/03/01 (2021).
20- Mostafa Nazari, Isaac Shiri, and Habib Zaidi, "Radiomics-based machine learning model to predict risk of death within 5-years in clear cell renal cell carcinoma patients." Computers in Biology and Medicine, Vol. 129p. 104135, 2021/02/01/ (2021).
21- I. Shiri et al., "Repeatability of radiomic features in magnetic resonance imaging of glioblastoma: Test-retest and image registration analyses." (in eng), Med Phys, Vol. 47 (No. 9), pp. 4265-80, Sep (2020).
22- B. Koçak, EŞ Durmaz, E. Ateş, and Ö Kılıçkesmez, "Radiomics with artificial intelligence: a practical guide for beginners." (in eng), Diagn Interv Radiol, Vol. 25 (No. 6), pp. 485-95, Nov (2019).
23- M. R. Tomaszewski and R. J. Gillies, "The Biological Meaning of Radiomic Features." (in eng), Radiology, Vol. 298 (No. 3), pp. 505-16, Mar (2021).
24- W. Gouda and R. Yasin, "COVID-19 disease: CT Pneumonia Analysis prototype by using artificial intelligence, predicting the disease severity." (in English), Egyptian Journal of Radiology and Nuclear Medicine, Article Vol. 51 (No. 1), (2020).
25- F. Shan et al., "Abnormal lung quantification in chest CT images of COVID-19 patients with deep learning and its application to severity prediction." (in eng), Med Phys, Vol. 48 (No. 4), pp. 1633-45, Apr (2021).
26- J. Mushtaq et al., "Initial chest radiographs and artificial intelligence (AI) predict clinical outcomes in COVID-19 patients: analysis of 697 Italian patients." (in English), European Radiology, Article Vol. 31 (No. 3), pp. 1770-79, (2021).
27- J. Bae et al., "Predicting mechanical ventilation and mortality in covid-19 using radiomics and deep learning on chest radiographs: A multi-institutional study." (in English), Diagnostics, Article Vol. 11 (No. 10), (2021).
28- M. R. H. Mondal, S. Bharati, and P. Podder, "Diagnosis of COVID-19 Using Machine Learning and Deep Learning: A Review." (in eng), Curr Med Imaging, Vol. 17 (No. 12), pp. 1403-18, (2021).
29- H. Wang, S. Jia, Z. Li, Y. Duan, G. Tao, and Z. Zhao, "A Comprehensive Review of Artificial Intelligence in Prevention and Treatment of COVID-19 Pandemic." (in eng), Front Genet, Vol. 13p. 845305, (2022).
30- M. Khan et al., "Applications of artificial intelligence in COVID-19 pandemic: A comprehensive review." (in eng), Expert Syst Appl, Vol. 185p. 115695, Dec 15 (2021).
31- L. Wang et al., "Artificial Intelligence for COVID-19: A Systematic Review." (in eng), Front Med (Lausanne), Vol. 8p. 704256, (2021).
32- Jawad Rasheed et al., "A survey on artificial intelligence approaches in supporting frontline workers and decision makers for the COVID-19 pandemic." Chaos, Solitons & Fractals, Vol. 141p. 110337, (2020).
33- Matthew DF McInnes et al., "Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies: the PRISMA-DTA statement." Jama, Vol. 319 (No. 4), pp. 388-96, (2018).
34- Simar Singh Bajaj, Alister Francois Martin, and Fatima Cody Stanford, "Health-based civic engagement is a professional responsibility." Nature Medicine, Vol. 27 (No. 10), pp. 1661-63, (2021).
35- Soroush Sadr et al., "Deep Learning for Detection of Periapical Radiolucent Lesions: A Systematic Review and Meta-analysis of Diagnostic Test Accuracy." Journal of Endodontics, 2022/12/21/ (2022).
36- Hossein Mohammad-Rahimi et al., "Deep learning in periodontology and oral implantology: A scoping review." Journal of Periodontal Research, Vol. 57 (No. 5), pp. 942-51, (2022).
37- Hossein Mohammad-Rahimi et al., "Deep learning for caries detection: A systematic review." Journal of Dentistry, Vol. 122p. 104115, 2022/07/01/ (2022).
38- Hossein Mohammad-Rahimi, Mohadeseh Nadimi, Mohammad Hossein Rohban, Erfan Shamsoddin, Victor Y. Lee, and Saeed Reza Motamedian, "Machine learning and orthodontics, current trends and the future opportunities: A scoping review." American Journal of Orthodontics and Dentofacial Orthopedics, Vol. 160 (No. 2), pp. 170-92.e4, 2021/08/01/ (2021).
39- Jane V Carter, Jianmin Pan, Shesh N Rai, and Susan %J Surgery Galandiuk, "ROC-ing along: Evaluation and interpretation of receiver operating characteristic curves." Vol. 159 (No. 6), pp. 1638-45, (2016).
40- SS Mahid, CA Hornung, KS Minor, M Turina, and S %J Journal of British Surgery Galandiuk, "Systematic reviews and meta-analysis for the surgeon scientist." Vol. 93 (No. 11), pp. 1315-24, (2006).
41- Jonathan J Deeks, Petra Macaskill, and Les Irwig, "The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed." Journal of clinical epidemiology, Vol. 58 (No. 9), pp. 882-93, (2005).
42- MMG Leeflang, "Systematic reviews and meta-analyses of diagnostic test accuracy." Clinical Microbiology and Infection, Vol. 20 (No. 2), pp. 105-13, (2014).
43- S. Ortiz, F. Rojas, O. Valenzuela, L. J. Herrera, and I. Rojas, "Determination of the Severity and Percentage of COVID-19 Infection through a Hierarchical Deep Learning System." (in eng), J Pers Med, Vol. 12 (No. 4), Mar 28 (2022).
44- Tuan Le Dinh, Suk-Hwan Lee, Seong-Geun Kwon, and Ki-Ryong Kwon, "COVID-19 Chest X-ray Classification and Severity Assessment Using Convolutional and Transformer Neural Networks." Applied Sciences, Vol. 12 (No. 10), p. 4861, (2022).
45- J. H. Chamberlin et al., "An Interpretable Chest CT Deep Learning Algorithm for Quantification of COVID-19 Lung Disease and Prediction of Inpatient Morbidity and Mortality." (in eng), Acad Radiol, Vol. 29 (No. 8), pp. 1178-88, Aug (2022).
46- H. M. Balaha, E. M. El-Gendy, and M. M. Saafan, "A complete framework for accurate recognition and prognosis of COVID-19 patients based on deep transfer learning and feature classification approach." (in eng), Artif Intell Rev, Vol. 55 (No. 6), pp. 5063-108, (2022).
47- J. Ahmad et al., "Disease Progression Detection via Deep Sequence Learning of Successive Radiographic Scans." (in eng), Int J Environ Res Public Health, Vol. 19 (No. 1), Jan 2 (2022).
48- P. Gifani, A. Shalbaf, and M. Vafaeezadeh, "Automated detection of COVID-19 using ensemble of transfer learning with deep convolutional neural network based on CT scans." (in eng), Int J Comput Assist Radiol Surg, Vol. 16 (No. 1), pp. 115-23, Jan (2021).
49- Wajid Arshad Abbasi, Syed Abbas, and Dr Saiqa Andleeb, COVIDX: Computer-aided diagnosis of Covid-19 and its severity prediction with raw digital chest X-ray images. (2020).
50- Hossein Aboutalebi, Maya Pavlova, Mohammad Javad Shafiee, Ali Sabri, Amer Alaref, and Alexander Wong, "COVID-Net CXR-S: Deep Convolutional Neural Network for Severity Assessment of COVID-19 Cases from Chest X-ray Images." Diagnostics, Vol. 12 (No. 1), p. 25, (2022).
51- M. D. Li et al., "Automated Assessment and Tracking of COVID-19 Pulmonary Disease Severity on Chest Radiographs using Convolutional Siamese Neural Networks." (in eng), Radiol Artif Intell, Vol. 2 (No. 4), p. e200079, Jul (2020).
52- Z. Li et al., "A deep-learning-based framework for severity assessment of COVID-19 with CT images." (in English), Expert Systems with Applications, Article Vol. 185(2021), Art no. 115616.
53- M. R. Ibrahim, S. M. Youssef, and K. M. Fathalla, "Abnormality detection and intelligent severity assessment of human chest computed tomography scans using deep learning: a case study on SARS-COV-2 assessment." (in English), Journal of Ambient Intelligence and Humanized Computing, Article (2021).
54- Y. Qiblawey et al., "Detection and severity classification of COVID-19 in CT images using deep learning." (in English), Diagnostics, Article Vol. 11 (No. 5), (2021).
55- Z. Jiao et al., "Prognostication of patients with COVID-19 using artificial intelligence based on chest x-rays and clinical data: a retrospective study." (in eng), Lancet Digit Health, Vol. 3 (No. 5), pp. e286-e94, May (2021).
56- N. Lassau et al., "Integrating deep learning CT-scan model, biological and clinical variables to predict severity of COVID-19 patients." (in English), Nature Communications, Article Vol. 12 (No. 1), (2021).
57- M. Elsharkawy et al., "Early assessment of lung function in coronavirus patients using invariant markers from chest X-rays images." (in eng), Sci Rep, Vol. 11 (No. 1), p. 12095, Jun 8 (2021).
58- W. Cai et al., "CT Quantification and Machine-learning Models for Assessment of Disease Severity and Prognosis of COVID-19 Patients." (in English), Academic Radiology, Article Vol. 27 (No. 12), pp. 1665-78, (2020).
59- S. Purkayastha et al., "Machine Learning-Based Prediction of COVID-19 Severity and Progression to Critical Illness Using CT Imaging and Clinical Data." (in English), Korean journal of radiology, Article Vol. 22 (No. 7), pp. 1213-24, (2021).
60- E. Irmak, "COVID-19 disease severity assessment using CNN model." (in eng), IET Image Process, Vol. 15 (No. 8), pp. 1814-24, Jun (2021).
61- T. T. Ho et al., "Deep Learning Models for Predicting Severe Progression in COVID-19-Infected Patients: Retrospective Study." (in eng), JMIR Med Inform, Vol. 9 (No. 1), p. e24973, Jan 28 (2021).
62- Christopher Gieraerts et al., "Prognostic Value and Reproducibility of AI-assisted Analysis of Lung Involvement in COVID-19 at Low-Dose Submillisievert Chest CT: Sample Size Implications for Clinical Trials." Radiology: Cardiothoracic Imaging, Vol. 2 (No. 5), p. e200441, (2020).
63- Y. Li et al., "Prediction of disease progression in patients with COVID-19 by artificial intelligence assisted lesion quantification." (in English), Scientific Reports, Article Vol. 10 (No. 1), (2020), Art no. 22083.
64- D. Bermejo-Peláez et al., "Deep learning-based lesion subtyping and prediction of clinical outcomes in COVID-19 pneumonia using chest CT." (in eng), Sci Rep, Vol. 12 (No. 1), p. 9387, Jun 7 (2022).
65- Isaac Shiri et al., "Machine learning-based prognostic modeling using clinical data and quantitative radiomic features from chest CT images in COVID-19 patients." Computers in biology and medicine, Vol. 132p. 104304, (2021).
66- I. Shiri et al., "COVID-19 prognostic modeling using CT radiomic features and machine learning algorithms: Analysis of a multi-institutional dataset of 14,339 patients." (in eng), Comput Biol Med, Vol. 145p. 105467, Jun (2022).
67- Lorenzo Spagnoli et al., "Outcome Prediction for SARS-CoV-2 Patients Using Machine Learning Modeling of Clinical, Radiological, and Radiomic Features Derived from Chest CT Images." Applied Sciences, Vol. 12 (No. 9), p. 4493, (2022).
68- A. F. Aljouie et al., "Early prediction of COVID-19 ventilation requirement and mortality from routinely collected baseline chest radiographs, laboratory, and clinical data with machine learning." (in English), Journal of Multidisciplinary Healthcare, Article Vol. 14pp. 2017-33, (2021).
69- Nida Aslam, "Explainable Artificial Intelligence Approach for the Early Prediction of Ventilator Support and Mortality in COVID-19 Patients." Computation, Vol. 10 (No. 3), p. 36, (2022).
70- T. U. Ahmed, M. N. Jamil, M. S. Hossain, R. U. Islam, and K. Andersson, "An Integrated Deep Learning and Belief Rule Base Intelligent System to Predict Survival of COVID-19 Patient under Uncertainty." (in eng), Cognit Comput, Vol. 14 (No. 2), pp. 660-76, (2022).
71- A. R. Kulkarni et al., "Deep learning model to predict the need for mechanical ventilation using chest X-ray images in hospitalised patients with COVID-19." (in English), BMJ Innovations, Article Vol. 7 (No. 2), pp. 261-70, (2021).
72- N. Munera et al., "A novel model to predict severe COVID-19 and mortality using an artificial intelligence algorithm to interpret chest radiographs and clinical variables." (in eng), ERJ Open Res, Vol. 8 (No. 2), Apr (2022).
73- J. H. Chamberlin et al., "Automated diagnosis and prognosis of COVID-19 pneumonia from initial ER chest X-rays using deep learning." (in eng), BMC Infect Dis, Vol. 22 (No. 1), p. 637, Jul 21 (2022).
74- F. Shan et al., "Abnormal lung quantification in chest CT images of COVID-19 patients with deep learning and its application to severity prediction." Medical Physics, Vol. 48 (No. 4), pp. 1633-45, Apr (2021).
75- Lucas de Pádua Gomes de Farias et al., "Imaging findings in COVID-19 pneumonia." Clinics, Vol. 75(2020).
76- Prabira Kumar Sethy, Santi Kumari Behera, Komma Anitha, Chanki Pandey, and MR Khan, "Computer aid screening of COVID-19 using X-ray and CT scan images: An inner comparison." Journal of X-ray Science and Technology, Vol. 29 (No. 2), pp. 197-210, (2021).
77- Pegah Moradi Khaniabadi et al., "Two-step machine learning to diagnose and predict involvement of lungs in COVID-19 and pneumonia using CT radiomics." Computers in biology and medicine, Vol. 150p. 106165, (2022).
78- Yan Li, Zhenlu Yang, Tao Ai, Shandong Wu, and Liming Xia, "Association of “initial CT” findings with mortality in older patients with coronavirus disease 2019 (COVID-19)." European Radiology, Vol. 30 (No. 11), pp. 6186-93, (2020).
79- Qiang Li et al., "A simple algorithm helps early identification of SARS-CoV-2 infection patients with severe progression tendency." Infection, Vol. 48 (No. 4), pp. 577-84, (2020).
80- Ilker Ozsahin, Boran Sekeroglu, Musa Sani Musa, Mubarak Taiwo Mustapha, and Dilber Uzun Ozsahin, "Review on diagnosis of COVID-19 from chest CT images using artificial intelligence." Computational and Mathematical Methods in Medicine, Vol. 2020(2020).
81- N. Hasani et al., "Trustworthy Artificial Intelligence in Medical Imaging." (in eng), PET Clin, Vol. 17 (No. 1), pp. 1-12, Jan (2022).
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Artificial Intelligence Deep Learning Machine Learning COVID-19 Prognosis |
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