Science
AI detects life-threatening blood vessel inflammation from Covid-19 variants
New artificial intelligence (AI) technology to scan for heightened blood vessel inflammation can calculate a person’s risk of death from Covid-19 and Covid-19 variants. The technology could be used to tailor their treatment and give them the best chance of recovery, according to new research we've funded and presented today at the British Cardiovascular Society conference.
Severe cases of Covid-19 have been associated with a ‘cytokine storm’, where the virus ‘Spike’ protein causes the immune system to go into overdrive and produces a surge of damaging molecules called cytokines.
Covid-19 'signature' detects red flags
Now, by using routine chest CT scans, researchers at the University of Oxford have developed a Covid-19 ‘signature’ using machine learning. The ‘signature’ detects biological red flags in the fat surrounding the blood vessels in the chest to measure the level of cytokine-driven vascular inflammation in people infected with the virus.
The team applied the Covid-19 signature to CT chest scans of 435 people admitted to hospitals in Oxford, Leicester and Bath, and compared the degree of inflammation and risk of death in people with and without Covid-19.
For patients admitted to hospital, the level of cytokine-driven inflammation in the blood vessels was much higher in those with Covid-19, and even greater in patients infected by the B.1.1.7 or ‘alpha’ variant first identified in the UK.
Anti-inflammatory drug reduces death risk
Those with a high level of vascular inflammation were up to eight times more likely to die in hospital, and were most likely to respond well to the anti-inflammatory drug Dexamethasone. Covid-19 patients with high vascular inflammation treated with Dexamethasone had a 6-fold reduction in risk of dying compared to Covid-19 patients who were not given the drug.
By using this tool to obtain an inflammation score, Covid-19 patients found to have a lot of inflammation in their blood vessels, and therefore increased risk of death, could potentially be given anti-inflammatory drugs to reduce their risk and help their long-term recovery. Clinical trials are now looking into the effectiveness of this approach.
Tracking the long term impact of Covid-19
Now, the researchers will continue to look at the impact of coronavirus variants as they emerge. They say that their technology may have immense power to easily track the long-term cardiovascular effects of Covid-19 and quickly respond to future viruses.
Professor Charalambos Antoniades, Professor of Cardiovascular Medicine and BHF Senior Clinical Research Fellow at the Radcliffe Department of Medicine, University of Oxford, said:
“By simply adding in one extra step to the routine care of people admitted to hospital with Covid-19 who already have a CT scan, we can now detect patients at high risk of life-threatening complications and could potentially tailor their treatment to aid long-term recovery.
“But the benefits don’t stop there. We know that this exaggerated immune response to the virus can also cause abnormal blood clotting, and so we are developing this AI platform to specifically identify Covid-19 patients who are most at risk of having a future heart attack or stroke. We can also pivot our platform with ease to develop a new scanning ‘signature’ to better understand future viruses and diseases that take hold of our population.”
AI tool could save lives
Our Associate Medical Director, Professor James Leiper said:
“Over the past year we have supported our scientists to direct their expertise to help the global effort in understanding Covid-19. This research clearly demonstrates that Covid-19 is a powerful virus that can wreak havoc on our circulatory system, and that different variants are associated with different levels of risk. There are still a lot of unknowns relating to how the virus can impact our health in the long term, but this AI tool could ultimately help to save lives.”
This research is one of the six research programmes chosen as UK Flagship Projects, all of which aim to improve care for people with heart and circulatory disease suffering from Covid-19. The initiative builds on a pre-existing partnership between us and the National Institute for Health Research (NIHR), and provides a new framework for the rapid set-up and delivery of urgent, high impact Covid-19 research projects across the UK.