COVID-19’s influence on cardiac function: a machine learning perspective on ECG analysis

Abstract

In December 2019, the spread of the SARS-CoV-2 virus to the world gave rise to probably the biggest public health problem in the world: the COVID-19 pandemic. Initially seen only as a disease of the respiratory system, COVID-19 is actually a blood disease with effects on the respiratory tract. Considering its influence on hematological parameters, how does COVID-19 affect cardiac function? Is it possible to support the clinical diagnosis of COVID-19 from the automatic analysis of electrocardiography? In this work, we sought to investigate how COVID-19 affects cardiac function using a machine learning approach to analyze electrocardiography (ECG) signals. We used a public database of ECG signals expressed as photographs of printed signals, obtained in the context of emergency care. This database has signals associated with abnormal heartbeat, myocardial infarction, history of myocardial infarction, COVID-19, and healthy heartbeat. We propose a system to support the diagnosis of COVID-19 based on hybrid deep architectures composed of pre-trained convolutional neural networks for feature extraction and Random Forests for classification. We investigated the LeNet, ResNet, and VGG16 networks. The best results were obtained with the VGG16 and Random Forest network with 100 trees, with attribute selection using particle swarm optimization. The instance size has been reduced from 4096 to 773 attributes. In the validation step, we obtained an accuracy of 94%, kappa index of 0.91, and sensitivity, specificity, and area under the ROC curve of 100%. This work showed that the influence of COVID-19 on cardiac function is quite considerable: COVID-19 did not present confusion with any heart disease, nor with signs of healthy individuals. It is also possible to build a solution to support the clinical diagnosis of COVID-19 in the context of emergency care from a non-invasive and technologically scalable solution, based on hybrid deep learning architectures. Graphical Abstract: [Figure not available: see fulltext.].