Machine learning model for predicting severity prognosis in patients infected with COVID-19: Study protocol from COVID-AI Brasil.

Journal: PloS one
Published Date:

Abstract

The new coronavirus, which began to be called SARS-CoV-2, is a single-stranded RNA beta coronavirus, initially identified in Wuhan (Hubei province, China) and currently spreading across six continents causing a considerable harm to patients, with no specific tools until now to provide prognostic outcomes. Thus, the aim of this study is to evaluate possible findings on chest CT of patients with signs and symptoms of respiratory syndromes and positive epidemiological factors for COVID-19 infection and to correlate them with the course of the disease. In this sense, it is also expected to develop specific machine learning algorithm for this purpose, through pulmonary segmentation, which can predict possible prognostic factors, through more accurate results. Our alternative hypothesis is that the machine learning model based on clinical, radiological and epidemiological data will be able to predict the severity prognosis of patients infected with COVID-19. We will perform a multicenter retrospective longitudinal study to obtain a large number of cases in a short period of time, for better study validation. Our convenience sample (at least 20 cases for each outcome) will be collected in each center considering the inclusion and exclusion criteria. We will evaluate patients who enter the hospital with clinical signs and symptoms of acute respiratory syndrome, from March to May 2020. We will include individuals with signs and symptoms of acute respiratory syndrome, with positive epidemiological history for COVID-19, who have performed a chest computed tomography. We will assess chest CT of these patients and to correlate them with the course of the disease. Primary outcomes:1) Time to hospital discharge; 2) Length of stay in the ICU; 3) orotracheal intubation;4) Development of Acute Respiratory Discomfort Syndrome. Secondary outcomes:1) Sepsis; 2) Hypotension or cardiocirculatory dysfunction requiring the prescription of vasopressors or inotropes; 3) Coagulopathy; 4) Acute Myocardial Infarction; 5) Acute Renal Insufficiency; 6) Death. We will use the AUC and F1-score of these algorithms as the main metrics, and we hope to identify algorithms capable of generalizing their results for each specified primary and secondary outcome.

Authors

  • Flávia Paiva Proença Lobo Lopes
    Departments of Radiology and Innovation, Diagnósticos da América (Dasa), São Paulo, São Paulo, Brasil.
  • Felipe Campos Kitamura
    From the Department of Radiology, Stanford University, 300 Pasteur Dr, MC 5105, Stanford, CA 94305 (S.S.H.); Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio (L.M.P.); Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, Mass (J.K.C.); Massachusetts General Hospital & Brigham and Women's Hospital Center for Clinical Data Science, Boston, Mass (A.B.M., K.A.); Department of Radiology, University of Toronto, Toronto, Ontario, Canada (A.B.); Department of Radiology, St. Michael's Hospital, Toronto, Ontario, Canada (M.C.); Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (I.P.); Universidade Federal de Goiás, Goiânia, Brazil (L.A.P., R.T.S.); Universidade Federal de São Paulo, São Paulo, Brazil (N.A., F.C.K.); Visiana, Hørsholm, Denmark (H.H.T.); MD.ai, New York, NY (L.C.); Department of Radiology, Weill Cornell Medicine, New York, NY (G.S.) Department of Radiology, University of California-San Francisco, San Francisco, Calif (M.D.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (B.J.E.); and Department of Radiology, Thomas Jefferson University, Philadelphia, Pa (A.E.F.).
  • Gustavo Faibischew Prado
    Department of Innovation, Hospital Alemão Oswaldo Cruz, São Paulo, São Paulo, Brasil.
  • Paulo Eduardo de Aguiar Kuriki
    Departments of Radiology and Innovation, Diagnósticos da América (Dasa), São Paulo, São Paulo, Brasil.
  • Marcio Ricardo Taveira Garcia
    Departments of Radiology and Innovation, Diagnósticos da América (Dasa), São Paulo, São Paulo, Brasil.