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Rapid Exclusion of COVID Infection With the Artificial Intelligence Electrocardiogram. Mayo Clinic proceedings Attia, Z. I., Kapa, S., Dugan, J., Pereira, N., Noseworthy, P. A., Jimenez, F. L., Cruz, J., Carter, R. E., DeSimone, D. C., Signorino, J., Halamka, J., Chennaiah Gari, N. R., Madathala, R. S., Platonov, P. G., Gul, F., Janssens, S. P., Narayan, S., Upadhyay, G. A., Alenghat, F. J., Lahiri, M. K., Dujardin, K., Hermel, M., Dominic, P., Turk-Adawi, K., Asaad, N., Svensson, A., Fernandez-Aviles, F., Esakof, D. D., Bartunek, J., Noheria, A., Sridhar, A. R., Lanza, G. A., Cohoon, K., Padmanabhan, D., Pardo Gutierrez, J. A., Sinagra, G., Merlo, M., Zagari, D., Rodriguez Escenaro, B. D., Pahlajani, D. B., Loncar, G., Vukomanovic, V., Jensen, H. K., Farkouh, M. E., Luescher, T. F., Su Ping, C. L., Peters, N. S., Friedman, P. A., Discover Consortium (Digital and Noninvasive Screening for COVID-19 with AI ECG Repository) 2021; 96 (8): 2081-2094

Abstract

OBJECTIVE: To rapidly exclude severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection using artificial intelligence applied to the electrocardiogram (ECG).METHODS: A global, volunteer consortium from 4 continents identified patients with ECGs obtained around the time of polymerase chain reaction-confirmed COVID-19 diagnosis and age- and sex-matched controls from the same sites. Clinical characteristics, polymerase chain reaction results, and raw electrocardiographic data were collected. A convolutional neural network wastrained using 26,153 ECGs (33.2% COVID positive), validated with 3826 ECGs (33.3% positive), and tested on 7870 ECGs not included in other sets (32.7% positive). Performance under different prevalence values was tested by adding control ECGs from a single high-volume site.RESULTS: The area under the curve for detection of acute COVID-19 infection in the test group was 0.767 (95% CI, 0.756 to 0.778; sensitivity, 98%; specificity, 10%; positive predictive value, 37%; negative predictive value, 91%). To more accurately reflect a real-world population, 50,905 normal controls were added to adjust the COVID prevalence to approximately 5% (2657/58,555), resulting in an area under the curve of 0.780 (95% CI, 0.771 to 0.790) with a specificity of 12.1% and a negative predictive value of 99.2%.CONCLUSION: Infection with SARS-CoV-2 results in electrocardiographic changes that permit the artificial intelligence-enhanced ECG to be used as a rapid screening test with a high negative predictive value (99.2%). This may permit the development of electrocardiography-based tools to rapidly screen individuals for pandemic control.

View details for DOI 10.1016/j.mayocp.2021.05.027

View details for PubMedID 34353468