In Frontiers in public health
The outbreak of coronavirus disease 2019 (COVID-19) has caused massive infections and large death tolls worldwide. Despite many studies on the clinical characteristics and the treatment plans of COVID-19, they rarely conduct in-depth prognostic research on leveraging consecutive rounds of multimodal clinical examination and laboratory test data to facilitate clinical decision-making for the treatment of COVID-19. To address this issue, we propose a multistage multimodal deep learning (MMDL) model to (1) first assess the patient's current condition (i.e., the mild and severe symptoms), then (2) give early warnings to patients with mild symptoms who are at high risk to develop severe illness. In MMDL, we build a sequential stage-wise learning architecture whose design philosophy embodies the model's predicted outcome and does not only depend on the current situation but also the history. Concretely, we meticulously combine the latest round of multimodal clinical data and the decayed past information to make assessments and predictions. In each round (stage), we design a two-layer multimodal feature extractor to extract the latent feature representation across different modalities of clinical data, including patient demographics, clinical manifestation, and 11 modalities of laboratory test results. We conduct experiments on a clinical dataset consisting of 216 COVID-19 patients that have passed the ethical review of the medical ethics committee. Experimental results validate our assumption that sequential stage-wise learning outperforms single-stage learning, but history long ago has little influence on the learning outcome. Also, comparison tests show the advantage of multimodal learning. MMDL with multimodal inputs can beat any reduced model with single-modal inputs only. In addition, we have deployed the prototype of MMDL in a hospital for clinical comparison tests and to assist doctors in clinical diagnosis.
Li Zhuo, Xu Ruiqing, Shen Yifei, Cao Jiannong, Wang Ben, Zhang Ying, Li Shikang
2022
COVID-19, disease progression prediction, disease severity assessment, multimodal feature fusion, sequential stage-wise learning
