The Report on China-Spain Joint Clinical Testing for Rapid COVID-19 Risk Screening by Eye-Region Manifestations

2021 
Background: The worldwide surge in coronavirus cases has led to the COVID-19 testing demand surge. Rapid, accurate, and cost-effective COVID-19 screening tests working at a population level are in imperative demand globally.  Methods: Based on the eye symptoms of COVID-19, we developed and tested a COVID-19 rapid prescreening model using the eye-region images captured in China and Spain with cellphone cameras. The convolutional neural networks (CNNs)-based model was trained on these eye images to complete binary classification task of identifying the COVID-19 cases. The performance was measured using area under receiver-operating-characteristic curve (AUC), sensitivity, specificity, accuracy, and F1. The application programming interface was open access. Findings: The multicenter study included 2436 pictures corresponding to 657 subjects (155 COVID-19 infection, 23·6%) in development dataset (train and validation) and 2138 pictures corresponding to 478 subjects (64 COVID-19 infections, 13·4%) in test dataset. The image-level performance of COVID-19 prescreening model in the China-Spain multicenter study achieved an AUC of 0·913 (95% CI, 0·898-0·927), with a sensitivity of 0·695 (95% CI, 0·643-0·748), a specificity of 0·904 (95% CI, 0·891 -0·919), an accuracy of 0·875(0·861-0·889), and a F1 of 0·611(0·568-0·655). Interpretation:The CNN-based model for COVID-19 rapid prescreening has reliable specificity and sensitivity. This system provides a low-cost, fully self-performed, non-invasive, real-time feedback solution for continuous surveillance and large-scale rapid prescreening for COVID-19.  Funding Information: This project is supported by Aimomics (Shanghai) Intelligent. Declaration of Interests: All other authors declare no competing interests. Ethics Approval Statement: The study was conducted in accordance with of the Declaration of Helsinki. The study protocol was approved by the Ethics Committee of Shanghai Public Health Clinical Center, Fudan University (approval No.: YJ-2020-S078-02), the fifth hospital of Shijiazhuang affiliated to Hebei Medical University (approval No.: 2021005), and the Ethics Committee on Drug Research of the University and Polytechnic Hospital La Fe (registry No: 2020-637-1). Informed consents were obtained from all participating individuals.
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