Robust Detection of COVID-19 in Cough Sounds: Using Recurrence Dynamics and Variable Markov Model

COVID-19, otherwise known as the coronavirus, has precipitated the world into a pandemic that has infected, as of the time of writing, more than 10 million persons worldwide and caused the death of more than 500,000 persons. Early symptoms of the virus include trouble breathing, fever and fatigue and over 60% of people experience a dry cough. Due to the devastating impact of COVID-19 and the tragic loss of lives, it is of the utmost urgency to develop methods for the early detection of the disease that may help limit its spread as well as aid in the development of targeted solutions. Coughs and other vocal sounds contain pulmonary health information that can be used for diagnostic purposes, and recent studies in chaotic dynamics have shown that nonlinear phenomena exist in vocal signals. The present work investigates the use of symbolic recurrence quantification measures with MFCC features for the automatic detection of COVID-19 in cough sounds of healthy and sick individuals. Our performance evaluation reveals that our symbolic dynamics measures capture the complex dynamics in the vocal sounds and are highly effective at discriminating sick and healthy coughs. We apply our method to sustained vowel 'ah' recordings, and show that our model is robust for the detection of the disease in sustained vowel utterances as well. Furthermore, we introduce a robust novel method of informative undersampling using information rate to deal with the imbalance in our dataset, due to the unavailability of an equal number of sick and healthy recordings. The proposed model achieves a mean classification performance of 97% and 99%, and a mean $$ -score of 91% and 89% after optimization, for coughs and sustained vowels, respectively.