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Introduction: SARS-CoV-2, a virus responsible for the emergence of the life-threatening disease known as COVID-19, exhibits a diverse range of clinical manifestations. The spectrum of symptoms varies widely, encompassing mild to severe presentations, while a considerable portion of the population remains asymptomatic. COVID-19, primarily a respiratory virus, has been linked to cardiovascular complications in some patients. Notably, cardiac issues can also arise after recovery, contributing to post-acute COVID-19 syndrome, a significant concern for patient health. The present study intends to evaluate the post-acute COVID-19 syndrome cardiovascular effect through ECG by comparing patients affected with cardiac diseases without COVID-19 diagnosis report (class 1) and patients with cardiac pathologies who present post-acute COVID-19 syndrome (class 2). Methods: From 2 body positions, a total of 10 non-linear features, extracted every 1 second under a multi-band analysis performed by Discrete Wavelet Transform (DWT), have been compressed by 6 statistical metrics to serve as inputs for an individual feature analysis by the means of Mann-Whitney U-test and XROC classification. Results and Discussion: 480 Mann-Whitney U-test statistical analyses and XROC discrimination approaches have been done. The percentage of statistical analysis with significant differences (p<0.05) was 30.42% (146 out of 480). The best overall results were obtained by approximating the feature Energy, with the data compressor Kurtosis in the body position Down. Those results were 83.33% of Accuracy, 83.33% of Sensitivity, 83.33% of Specificity and 87.50% of AUC. Conclusions: The results show that the applied methodology can be a way to show changes in cardiac behaviour provoked by post-acute COVID-19 syndrome.
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Objective: This study highlights the potential of an Electrocardiogram (ECG) as a powerful tool for early diagnosis of COVID-19 in critically ill patients with limited access to CT–Scan rooms. Methods: In this investigation, 3 categories of patient status were considered: Low, Moderate, and Severe. For each patient, 2 different body positions have been used to collect 2 ECG signals. Then, from each collected signal, 10 non-linear features (Energy, Approximate Entropy, Logarithmic Entropy, Shannon Entropy, Hurst Exponent, Lyapunov Exponent, Higuchi Fractal Dimension, Katz Fractal Dimension, Correlation Dimension and Detrended Fluctuation Analysis) were extracted every 1s ECG time-series length to serve as entries for 19 Machine learning classifiers within a leave-one-out cross-validation procedure. Four different classification scenarios were tested: Low vs. Moderate, Low vs. Severe, Moderate vs. Severe and one Multi-class comparison (All vs. All). Results: The classification report results were: (1) Low vs. Moderate - 100% of Accuracy and 100% of F1–Score; (2) Low vs. Severe - Accuracy of 91.67% and an F1–Score of 94.92%; (3) Moderate vs. Severe - Accuracy of 94.12% and an F1–Score of 96.43%; and (4) All vs All - 78.57% of Accuracy and 84.75% of F1–Score. Conclusion: The results indicate that the applied methodology could be considered a good tool for distinguishing COVID-19’s different severity stages using ECG signals. Significance: The findings highlight the potential of ECG as a fast and effective tool for COVID-19 examination. In comparison to previous studies using the same database, this study shows a 7.57% improvement in diagnostic accuracy for the All vs All comparison.
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