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Register a new userAI4COVID-19: AI Enabled Preliminary Diagnosis for COVID-19 from Cough Samples via an App
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Background: The inability to test at scale has become humanitys Achilles heel in the ongoing war against the COVID-19 pandemic. A scalable screening tool would be a game changer. Building on the prior work on cough-based diagnosis of respiratory diseases, we propose, develop and test an Artificial Intelligence (AI)-powered screening solution for COVID-19 infection that is deployable via a smartphone app. The app, named AI4COVID-19 records and sends three 3-second cough sounds to an AI engine running in the cloud, and returns a result within two minutes. Methods: Cough is a symptom of over thirty non-COVID-19 related medical conditions. This makes the diagnosis of a COVID-19 infection by cough alone an extremely challenging multidisciplinary problem. We address this problem by investigating the distinctness of pathomorphological alterations in the respiratory system induced by COVID-19 infection when compared to other respiratory infections. To overcome the COVID-19 cough training data shortage we exploit transfer learning. To reduce the misdiagnosis risk stemming from the complex dimensionality of the problem, we leverage a multi-pronged mediator centered risk-averse AI architecture. Results: Results show AI4COVID-19 can distinguish among COVID-19 coughs and several types of non-COVID-19 coughs. The accuracy is promising enough to encourage a large-scale collection of labeled cough data to gauge the generalization capability of AI4COVID-19. AI4COVID-19 is not a clinical grade testing tool. Instead, it offers a screening tool deployable anytime, anywhere, by anyone. It can also be a clinical decision assistance tool used to channel clinical-testing and treatment to those who need it the most, thereby saving more lives.
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In the pathogenesis of COVID-19, impairment of respiratory functions is often one of the key symptoms. Studies show that in these cases, voice production is also adversely affected -- vocal fold oscillations are asynchronous, asymmetrical and more restricted during phonation. This paper proposes a method that analyzes the differential dynamics of the glottal flow waveform (GFW) during voice production to identify features in them that are most significant for the detection of COVID-19 from voice. Since it is hard to measure this directly in COVID-19 patients, we infer it from recorded speech signals and compare it to the GFW computed from physical model of phonation. For normal voices, the difference between the two should be minimal, since physical models are constructed to explain phonation under assumptions of normalcy. Greater differences implicate anomalies in the bio-physical factors that contribute to the correctness of the physical model, revealing their significance indirectly. Our proposed method uses a CNN-based 2-step attention model that locates anomalies in time-feature space in the difference of the two GFWs, allowing us to infer their potential as discriminative features for classification. The viability of this method is demonstrated using a clinically curated dataset of COVID-19 positive and negative subjects.
The INTERSPEECH 2021 Computational Paralinguistics Challenge addresses four different problems for the first time in a research competition under well-defined conditions: In the COVID-19 Cough and COVID-19 Speech Sub-Challenges, a binary classification on COVID-19 infection has to be made based on coughing sounds and speech; in the Escalation SubChallenge, a three-way assessment of the level of escalation in a dialogue is featured; and in the Primates Sub-Challenge, four species vs background need to be classified. We describe the Sub-Challenges, baseline feature extraction, and classifiers based on the usual COMPARE and BoAW features as well as deep unsupervised representation learning using the AuDeep toolkit, and deep feature extraction from pre-trained CNNs using the Deep Spectrum toolkit; in addition, we add deep end-to-end sequential modelling, and partially linguistic analysis.
In the break of COVID-19 pandemic, mass testing has become essential to reduce the spread of the virus. Several recent studies suggest that a significant number of COVID-19 patients display no physical symptoms whatsoever. Therefore, it is unlikely that these patients will undergo COVID-19 test, which increases their chances of unintentionally spreading the virus. Currently, the primary diagnostic tool to detect COVID-19 is RT-PCR test on collected respiratory specimens from the suspected case. This requires patients to travel to a laboratory facility to be tested, thereby potentially infecting others along the way.It is evident from recent researches that asymptomatic COVID-19 patients cough and breath in a different way than the healthy people. Several research groups have created mobile and web-platform for crowdsourcing the symptoms, cough and breathing sounds from healthy, COVID-19 and Non-COVID patients. Some of these data repositories were made public. We have received such a repository from Cambridge University team under data-sharing agreement, where we have cough and breathing sound samples for 582 and 141 healthy and COVID-19 patients, respectively. 87 COVID-19 patients were asymptomatic, while rest of them have cough. We have developed an Android application to automatically screen COVID-19 from the comfort of people homes. Test subjects can simply download a mobile application, enter their symptoms, record an audio clip of their cough and breath, and upload the data anonymously to our servers. Our backend server converts the audio clip to spectrogram and then apply our state-of-the-art machine learning model to classify between cough sounds produced by COVID-19 patients, as opposed to healthy subjects or those with other respiratory conditions. The system can detect asymptomatic COVID-19 patients with a sensitivity more than 91%.
Testing capacity for COVID-19 remains a challenge globally due to the lack of adequate supplies, trained personnel, and sample-processing equipment. These problems are even more acute in rural and underdeveloped regions. We demonstrate that solicited-cough sounds collected over a phone, when analysed by our AI model, have statistically significant signal indicative of COVID-19 status (AUC 0.72, t-test,p <0.01,95% CI 0.61-0.83). This holds true for asymptomatic patients as well. Towards this, we collect the largest known(to date) dataset of microbiologically confirmed COVID-19 cough sounds from 3,621 individuals. When used in a triaging step within an overall testing protocol, by enabling risk-stratification of individuals before confirmatory tests, our tool can increase the testing capacity of a healthcare system by 43% at disease prevalence of 5%, without additional supplies, trained personnel, or physical infrastructure
Phonation, or the vibration of the vocal folds, is the primary source of vocalization in the production of voiced sounds by humans. It is a complex bio-mechanical process that is highly sensitive to changes in the speakers respiratory parameters. Since most symptomatic cases of COVID-19 present with moderate to severe impairment of respiratory functions, we hypothesize that signatures of COVID-19 may be observable by examining the vibrations of the vocal folds. Our goal is to validate this hypothesis, and to quantitatively characterize the changes observed to enable the detection of COVID-19 from voice. For this, we use a dynamical system model for the oscillation of the vocal folds, and solve it using our recently developed ADLES algorithm to yield vocal fold oscillation patterns directly from recorded speech. Experimental results on a clinically curated dataset of COVID-19 positive and negative subjects reveal characteristic patterns of vocal fold oscillations that are correlated with COVID-19. We show that these are prominent and discriminative enough that even simple classifiers such as logistic regression yields high detection accuracies using just the recordings of isolated extended vowels.
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