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      Genetic‐based adaptive momentum estimation for predicting mortality risk factors for COVID‐19 patients using deep learning

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          Abstract

          The mortality risk factors for coronavirus disease (COVID‐19) must be early predicted, especially for severe cases, to provide intensive care before they develop to critically ill immediately. This paper aims to develop an optimized convolution neural network (CNN) for predicting mortality risk factors for COVID‐19 patients. The proposed model supports two types of input data clinical variables and the computed tomography (CT) scans. The features are extracted from the optimized CNN phase and then applied to the classification phase. The CNN model's hyperparameters were optimized using a proposed genetic‐based adaptive momentum estimation (GB‐ADAM) algorithm. The GB‐ADAM algorithm employs the genetic algorithm (GA) to optimize Adam optimizer's configuration parameters, consequently improving the classification accuracy. The model is validated using three recent cohorts from New York, Mexico, and Wuhan, consisting of 3055, 7497,504 patients, respectively. The results indicated that the most significant mortality risk factors are: CD 8 + T Lymphocyte (Count), D‐dimer greater than 1 Ug/ml, high values of lactate dehydrogenase (LDH), C‐reactive protein (CRP), hypertension, and diabetes. Early identification of these factors would help the clinicians in providing immediate care. The results also show that the most frequent COVID‐19 signs in CT scans included ground‐glass opacity (GGO), followed by crazy‐paving pattern, consolidations, and the number of lobes. Moreover, the experimental results show encouraging performance for the proposed model compared with different predicting models.

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          Most cited references31

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

            Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
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              A Novel Coronavirus from Patients with Pneumonia in China, 2019

              Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
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                Author and article information

                Contributors
                aboitcairo@gmail.com
                Journal
                Int J Imaging Syst Technol
                Int J Imaging Syst Technol
                10.1002/(ISSN)1098-1098
                IMA
                International Journal of Imaging Systems and Technology
                John Wiley & Sons, Inc. (Hoboken, USA )
                0899-9457
                1098-1098
                13 August 2021
                13 August 2021
                : 10.1002/ima.22644
                Affiliations
                [ 1 ] MISR Higher Institute for Engineering and Technology Egypt
                [ 2 ] Faculty of Computers and Artificial Intelligence Cairo University Giza Egypt
                [ 3 ] Department of Computer Science Lulea University of Technology (LTU) Sweden
                [ 4 ] Department of Electrical and Data Engineering University of Technology Sydney (UTS) Australia
                Author notes
                [*] [* ] Correspondence

                Aboul Ella Hassanien, Cairo University, Faculty of Computers and Artificial Intellgence, Giza, Egypt.

                Email: aboitcairo@ 123456cu.edu.eg

                [ * ]

                Scientific Research Group in Egypt (SRGE) www.egyptscience.net

                Author information
                https://orcid.org/0000-0002-5430-390X
                https://orcid.org/0000-0002-9989-6681
                https://orcid.org/0000-0003-1902-9877
                Article
                IMA22644
                10.1002/ima.22644
                8426801
                34518740
                659bd62f-f60b-4753-9279-d259ab8058c4
                © 2021 Wiley Periodicals LLC.

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 12 July 2021
                : 12 December 2020
                : 14 July 2021
                Page count
                Figures: 9, Tables: 5, Pages: 15, Words: 7285
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.7 mode:remove_FC converted:09.09.2021

                artificial intelligence,classification algorithms,deep learning,evolutionary computation,genetic algorithms,hybrid intelligent systems,medical diagnostic,predictive model

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