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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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The continuous development of robust machine learning algorithms in recent years has helped to improve the solutions of many studies in many fields of medicine, rapid diagnosis and detection of high-risk patients with poor prognosis as the coronavirus disease 2019 (COVID-19) spreads globally, and also early prevention of patients and optimization of medical resources. Here, we propose a fully automated machine learning system to classify the severity of COVID-19 from electrocardiogram (ECG) signals. We retrospectively collected 100 5-minute ECGs from 50 patients in two different positions, upright and supine. We processed the surface ECG to obtain QRS complexes and HRV indices for RR series, including a total of 43 features. We compared 19 machine learning classification algorithms that yielded different approaches explained in a methodology session.
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In 2020, the World Health Organization declared the Coronavirus Disease 19 a global pandemic. While detecting COVID-19 is essential in controlling the disease, prognosis prediction is crucial in reducing disease complications and patient mortality. For that, standard protocols consider adopting medical imaging tools to analyze cases of pneumonia and complications. Nevertheless, some patients develop different symptoms and/or cannot be moved to a CT-Scan room. In other cases, the devices are not available. The adoption of ambulatory monitoring examinations, such as Electrocardiography (ECG), can be considered a viable tool to address the patient’s cardiovascular condition and to act as a predictor for future disease outcomes. In this investigation, ten 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) extracted from 2 ECG signals (collected from 2 different patient’s positions). Windows of 1 second segments in 6 ways of windowing signal analysis crops were evaluated employing statistical analysis. Three categories of outcomes are considered for the patient status: Low, Moderate, and Severe, and four combinations for classification scenarios are tested: (Low vs. Moderate, Low vs. Severe, Moderate vs. Severe) and 1 Multi-class comparison (All vs. All)). The results indicate that some statistically significant parameter distributions were found for all comparisons. (Low vs. Moderate—Approximate Entropy p-value = 0.0067 < 0.05, Low vs. Severe—Correlation Dimension p-value = 0.0087 < 0.05, Moderate vs. Severe—Correlation Dimension p-value = 0.0029 < 0.05, All vs. All—Correlation Dimension p-value = 0.0185 < 0.05. The non-linear analysis of the time-frequency representation of the ECG signal can be considered a promising tool for describing and distinguishing the COVID-19 severity activity along its different stages.
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The COVID-19 pandemic has posed a significant public health challenge on a global scale. It is imperative that we continue to undertake research in order to identify early markers of disease progression, enhance patient care through prompt diagnosis, identification of high-risk patients, early prevention, and efficient allocation of medical resources. In this particular study, we obtained 100 5-min electrocardiograms (ECGs) from 50 COVID-19 volunteers in two different positions, namely upright and supine, who were categorized as either moderately or critically ill. We used classification algorithms to analyze heart rate variability (HRV) metrics derived from the ECGs of the volunteers with the goal of predicting the severity of illness. Our study choose a configuration pro SVC that achieved 76% of accuracy, and 0.84 on F1 Score in predicting the severity of Covid-19 based on HRV metrics.
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