Evidence map›Paper›PMID 40729327›Full record

ArticlePloS one2025

Differentiation of COVID-19 from other types of viral pneumonia and severity scoring on baseline chest radiographs: Comparison of deep learning with multi-reader evaluation.

Nastaran Enshaei, Arash Mohammadi, Farnoosh Naderkhani, Nick Daneman, Rawan Abu Mughli, Reut Anconina, Ferco H Berger, Robert Andrew Kozak, Samira Mubareka, Ana Maria Villanueva Campos and 6 more

Abstract readComparative Study
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Nastaran EnshaeiConcordia Institute for Information Systems Engineering, Concordia University, Montreal, Quebec, Canada.
Arash MohammadiConcordia Institute for Information Systems Engineering, Concordia University, Montreal, Quebec, Canada.
Farnoosh NaderkhaniConcordia Institute for Information Systems Engineering, Concordia University, Montreal, Quebec, Canada.
Nick DanemanDepartment of Medicine, Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Rawan Abu MughliDepartment of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Reut AnconinaDepartment of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Ferco H BergerDepartment of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.ORCID https://orcid.org/0000-0003-3696-2554
Robert Andrew KozakBiological Sciences Platform, Sunnybrook Research Institute and Shared Hospital Laboratory, Toronto, Canada.
Samira MubarekaDepartment of Microbiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Ana Maria Villanueva CamposDepartment of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Keshav NarangDepartment of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Thayalasuthan VivekanandanDepartment of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Adrienne Kit ChanDepartment of Medicine, Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Philip LamDepartment of Medicine, Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Nisha AndanyDepartment of Medicine, Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Anastasia OikonomouDepartment of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.ORCID https://orcid.org/0000-0001-6996-237X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chest X-ray (CXR) imaging plays a pivotal role in the diagnosis and prognosis of viral pneumonia. However, distinguishing COVID-19 CXRs from other viral infections remains challenging due to highly similar radiographic features. Most existing deep learning (DL) models focus on differentiating COVID-19 from community-acquired pneumonia (CAP) rather than other viral pneumonias and often overlook baseline CXRs, missing the critical window for early detection and intervention. Moreover, manual severity scoring of COVID-19 CXRs by radiologists is subjective and time-intensive, highlighting the need for automated systems. This study introduces a DL system for distinguishing COVID-19 from other viral pneumonias on baseline CXRs acquired within three days of PCR testing, and for automated severity scoring of COVID-19 CXRs. The system was developed using a dataset of 2,547 patients (808 COVID-19, 936 non-COVID viral pneumonia, and 803 normal cases) and validated externally on several publicly accessible datasets. Compared to four experienced radiologists, the model achieved higher diagnostic accuracy (76.4% vs. 71.8%) and enhanced COVID-19 identification (F1-score: 74.1% vs. 61.3%), with an AUC of 93% for distinguishing between viral pneumonia and normal cases, and 89.8% for differentiating COVID-19 from other viral pneumonias. The severity-scoring module exhibited a high Pearson correlation of 93% and a low mean absolute error (MAE) of 2.35 compared to the radiologists' consensus. External validation on independent public datasets confirmed the model's generalizability. Subgroup analyses stratified by patient age, sex, and severity levels further demonstrated consistent performance, supporting the system's robustness across diverse clinical populations. These findings suggest that the proposed DL system could assist radiologists in the early diagnosis and severity assessment of COVID-19 from baseline CXRs, particularly in resource-limited settings.

Indexed as

COVID-19Deep LearningPneumonia, ViralRadiography, ThoracicAdultAgedCommunity-Acquired InfectionsDiagnosis, DifferentialFemaleHumansMaleMiddle AgedSARS-CoV-2Severity of Illness Index

Identifiers

PMID40729327
PMCPMC12306774

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.