During the flu season, viral pneumonia is prevalent, and CXR radiography has a critical role in frontline patient care. Chest X-ray (CXR) radiography is the mainstay of screening, triaging and diagnosing varieties of pneumonia, including bacterial, viral and other types of pneumonia 5, 6, 7. The viral infection frequently presents as an infection of the upper respiratory tract or pneumonia (COVID-19 pneumonia) that can rapidly progress to acute respiratory failure, multiple organ failure and death. The genome of the new virus and the epidemiological and clinical features of the infection have been reported 1, 2, 3, 4. The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated disease, COVID-19, led to a pandemic of the highest concern 1, 2, 3, 4, 5, 6. Automated deep-learning systems for the assessment of pneumonia could facilitate early intervention and provide support for clinical decision-making. In an independent set of 440 chest X-rays, the system performed comparably to senior radiologists and improved the performance of junior radiologists. The system generalized across settings, discriminating between viral pneumonia, other types of pneumonia and the absence of disease with areas under the receiver operating characteristic curve (AUCs) of 0.94–0.98 between severe and non-severe COVID-19 with an AUC of 0.87 and between COVID-19 pneumonia and other viral or non-viral pneumonia with AUCs of 0.87–0.97. The deep-learning system was developed using a heterogeneous multicentre dataset of 145,202 images, and tested retrospectively and prospectively with thousands of additional images across four patient cohorts and multiple countries. Here, we show that a fully automated deep-learning pipeline for the standardization of chest X-ray images, for the visualization of lesions and for disease diagnosis can identify viral pneumonia caused by coronavirus disease 2019 (COVID-19) and assess its severity, and can also discriminate between viral pneumonia caused by COVID-19 and other types of pneumonia. ![]() Nature Biomedical Engineering volume 5, pages 509–521 ( 2021) Cite this articleĬommon lung diseases are first diagnosed using chest X-rays. A deep-learning pipeline for the diagnosis and discrimination of viral, non-viral and COVID-19 pneumonia from chest X-ray images
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