Abstract

Artificial intelligence (AI) systems for detection of COVID-19 using chest X-Ray (CXR) imaging and point-of-care blood tests were applied to data from four low resource African settings. The performance of these systems to detect COVID-19 using various input data was analysed and compared with antigen-based rapid diagnostic tests. Participants were tested using the gold standard of RT-PCR test (nasopharyngeal swab) to determine whether they were infected with SARS-CoV-2. A total of 3737 (260 RT-PCR positive) participants were included. In our cohort, AI for CXR images was a poor predictor of COVID-19 (AUC = 0.60), since the majority of positive cases had mild symptoms and no visible pneumonia in the lungs. AI systems using differential white blood cell counts (WBC), or a combination of WBC and C-Reactive Protein (CRP) both achieved an AUC of 0.74 with a suggested optimal cut-off point at 83% sensitivity and 63% specificity. The antigen-RDT tests in this trial obtained 65% sensitivity at 98% specificity. This study is the first to validate AI tools for COVID-19 detection in an African setting. It demonstrates that screening for COVID-19 using AI with point-of-care blood tests is feasible and can operate at a higher sensitivity level than antigen testing.

Details

Title
COVID-19 screening in low resource settings using artificial intelligence for chest radiographs and point-of-care blood tests
Author
Murphy, Keelin 1 ; Muhairwe, Josephine 2 ; Schalekamp, Steven 1 ; van Ginneken, Bram 1 ; Ayakaka, Irene 2 ; Mashaete, Kamele 2 ; Katende, Bulemba 2 ; van Heerden, Alastair 3 ; Bosman, Shannon 4 ; Madonsela, Thandanani 4 ; Gonzalez Fernandez, Lucia 5 ; Signorell, Aita 6 ; Bresser, Moniek 6 ; Reither, Klaus 6 ; Glass, Tracy R. 6 

 Radboud University Medical Center, Nijmegen, The Netherlands (GRID:grid.10417.33) (ISNI:0000 0004 0444 9382) 
 SolidarMed, Partnerships for Health, Maseru, Lesotho (GRID:grid.10417.33) 
 Human Sciences Research Council, Centre for Community Based Research, Pietermaritzburg, South Africa (GRID:grid.417715.1) (ISNI:0000 0001 0071 1142); University of the Witwatersrand, SAMRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, Johannesburg, South Africa (GRID:grid.11951.3d) (ISNI:0000 0004 1937 1135) 
 Human Sciences Research Council, Centre for Community Based Research, Pietermaritzburg, South Africa (GRID:grid.417715.1) (ISNI:0000 0001 0071 1142) 
 University Hospital Basel, Department of Infectious Diseases and Hospital Epidemiology, Basel, Switzerland (GRID:grid.410567.1); SolidarMed, Partnerships for Health, Lucerne, Switzerland (GRID:grid.410567.1) 
 Swiss Tropical and Public Health Institute, Allschwil, Switzerland (GRID:grid.416786.a) (ISNI:0000 0004 0587 0574); University of Basel, Basel, Switzerland (GRID:grid.6612.3) (ISNI:0000 0004 1937 0642) 
Pages
19692
Publication year
2023
Publication date
2023
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2888703376
Copyright
© The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.