Voice and the new corona virus
The new corona virus has become a global health concern, as 1.537.173
cases worldwide are declared today with 89.954 associated deaths.[1]
Researchers around the world are looking for solutions for early
detection, monitoring of the evolution of viral infection, etiological
or pathophysiological treatment.
Voice is a unique human attribute. Voice has the potential to provide an
easily obtained, non-invasive way to monitor physiological changes
throughout the body. To produce the sounds, we need a system: the
respiratory tract, the phonator, and the articulators. Respiration is
necessary to produce the pressure and vibration: the air passes through
the larynx, tissues vibrate to produce sound waves, and articulators are
the shaping of raw sound into recognizable speech. Normal voice
production depends on power and airflow supplied by the respiratory
system. Any disturbance in one of the three subsystems of voice
production may lead to a voice disorder. Recognizing associations among
these factors, along with patient history, may help in identifying the
possible causes of the voice disorder.[2]
Voice-related features were found to have a predictive value for
different pathologies. A glottal-flow spectrum and vocal jitter were
found to discriminate near-term risk suicidal adolescents.[6] Some
studies have attempted to quantify voice parameters (acoustic amplitude,
frequency variations), with the purpose of characterizing the
Parkinson’s disease dysphonic symptoms.[7] Wheezing and coughing,
trouble breathing, coughing up mucus and shortness of breath are just a
few chronic obstructive pulmonary disease (COPD) symptoms and many
patients experience voice changes due to COPD.[8] In their pilot
study, Murton et al.[9] analyzed the voices of heart failure (HF)
patients as they underwent treatment for decompensated HF and returned
to a stable clinical state.
How the voice acoustical analysis can help us identifying respiratory
and breathing problems, the main concern today regarding patients with
CoViD-19? Voice processing has become a fast-growing field. Voice
disorder databases can be used in clinics as well as in automatic voice
disorder detection systems to study the acoustic behavior of the voices.
Audio recording is the most important basic requisite for voice quality
assessment.[2] Coordination between the larynx and lower airways is
essential for normal voice production. While most people with COVID-19
develop only mild or uncomplicated illness, approximately 14% develop
severe disease that requires hospitalization and oxygen support, and 5%
require admission to an ICU.[7] In severe cases, COVID-19 can be
complicated by the acute respiratory distress syndrome (ARDS), sepsis
and septic shock, multiorgan failure, including acute kidney injury and
cardiac injury.[8] It may be possible to monitor a person’s health
remotely – using smartphones – by recording short speech samples and
analyzing them for disease biomarkers. A vocal test app on a smartphone
could be used as a tool to identify patients most at risk of respiratory
failure. For health care providers with experience in the clinical
management of patients with COVID-19 and other viral infections,
including SARS and MERS, as well as sepsis and ARDS, the application of
acoustical voice analysis should serve as a foundation for optimized
supportive care to ensure the best possible chance for survival.