COUGHVID Final Published
COUGHVID Final Published
com/scientificdata
Cough audio signal classification has been successfully used to diagnose a variety of respiratory
conditions, and there has been significant interest in leveraging Machine Learning (ML) to provide
widespread COVID-19 screening. The COUGHVID dataset provides over 25,000 crowdsourced cough
recordings representing a wide range of participant ages, genders, geographic locations, and COVID-19
statuses. First, we contribute our open-sourced cough detection algorithm to the research community
to assist in data robustness assessment. Second, four experienced physicians labeled more than 2,800
recordings to diagnose medical abnormalities present in the coughs, thereby contributing one of the
largest expert-labeled cough datasets in existence that can be used for a plethora of cough audio
classification tasks. Finally, we ensured that coughs labeled as symptomatic and COVID-19 originate
from countries with high infection rates. As a result, the COUGHVID dataset contributes a wealth of
cough recordings for training ML models to address the world’s most urgent health crises.
1
Embedded Systems Laboratory (ESL), EPFL, Lausanne, 1015, Switzerland. 2These authors contributed equally: Lara
Orlandic, Tomas Teijeiro. ✉e-mail: [email protected]
from around the world, it is the largest known public COVID-19-related cough sound dataset in existence. In
addition to publicly providing most of our cough corpus, we have trained and open-sourced a cough detec-
tion ML model to filter non-cough recordings from the database. This automated cough detection tool assists
developers in creating robust applications that automatically remove non-cough sounds from their databases.
Furthermore, our open-sourced cough detection model, preprocessing methods, cough segmentation algo-
rithm, and SNR estimation code enable the research community to seamlessly integrate their own datasets with
COUGHVID while keeping the data processing pipeline consistent.
We have undergone an additional layer of validation whereby four expert physicians annotated a fraction of
the dataset to determine which crowdsourced samples realistically originate from COVID-19 patients. In addi-
tion to COVID-19 diagnoses, our expert labels and metadata provide a wealth of insights beyond those of exist-
ing public cough datasets. These datasets either do not provide labels or contain a small number of samples. For
example, the Google Audio Set12 contains 871 cough sounds, but it does not specify the diagnoses or pathologies
of the coughs. Conversely, the IIIT-CSSD13 labels coughs as wet vs dry and short-term vs long-term ailments,
but it only includes 30 unique subjects. The COUGHVID dataset publicly contributes over 2,800 expert-labeled
coughs, all of which provide a diagnosis, severity level, and whether or not audible health anomalies are present,
such as dyspnea, wheezing, and nasal congestion. Using these expert labels along with participant metadata,
our dataset can be used to train models that detect a variety of participants’ information based on their cough
sounds. Overall, our dataset contains samples from a wide array of participant ages, genders, COVID-19 statuses,
pre-existing respiratory conditions, and geographic locations, which potentially enable ML models to successfully
perform generalization.
Finally, we ensure that samples labeled as COVID-19 originate from countries where the virus was prevalent
at the time of recording, and we perform an evaluation of the quality of the recordings containing cough sounds.
The first step to building robust AI algorithms for the detection of COVID-19 from cough sounds is having an
extensive dataset, and the COUGHVID dataset effectively meets this pressing global need.
Methods
Data collection. All of the recordings were collected between April 1st, 2020 and December 1st, 2020
through a Web application deployed on a private server located at the facilities of the École Polytechnique
Fédérale de Lausanne (EPFL), Switzerland. The application was designed with a simple workflow and following
the principle “one recording, one click”, according to which if someone simply wants to send a cough recording,
they should have to click on no more than one item.
The main Web interface has just one “Record” button that starts recording audio from the microphone for up
to 10 seconds. Once the audio recording is completed, a small questionnaire is shown to get some metadata about
the age, gender, and current condition of the user, but even if the questionnaire is not filled, the audio is sent to
the server. The variables captured in the questionnaire are described in Table 1. Also, the user is asked for per-
mission to provide their geolocation information, which is not mandatory. Finally, since coughing is a potentially
dangerous activity in the scope of a global pandemic, we provide easy-to-follow safe coughing instructions, such
as coughing into the elbow and holding the phone at arm’s length, that can be accessed from the main screen.
Database cleaning. A common pitfall of crowdsourced data is that it frequently contains samples unrelated
to the desired content of the database. In order to allow users of the COUGHVID dataset to quickly exclude
non-cough sounds from their analyses, we developed a classifier to determine the degree of certainty to which a
given recording contains a cough sound. These output probabilities of the classifier were subsequently included in
the metadata of each record under the cough_detected entry. The recordings determined by the ML model
to be non-cough sounds are included in the database and can be utilized by developers to enhance the robustness
of their applications, such as alerting users when they do not upload a valid cough sound. Developers may use
these samples to train their own classifiers to detect specific sounds, such as breathing or wheezing, and create
many other possible applications.
To train the classifier, we employed similar procedures to those of state-of-the-art cough classification models14.
We first randomly selected a set of 215 recordings from our database. Then, we manually classified each record-
ing as a cough sound if at least one cough was present, otherwise listing it as a non-cough sound. In the case
that a recording contained both cough and non-cough audio events, the recording was discarded and a new
one was randomly selected from the database. This process resulted in a nearly balanced sample of 121 cough
sounds and 94 non-cough sounds including speaking, laughing, silence, and miscellaneous background noises.
These recordings were preprocessed by lowpass filtering (fcutoff = 6 kHz) and downsampling to 12 kHz. Next, 68
audio features commonly used for cough classification were extracted from each recording. The details of these
state-of-the-art features are listed in Table 2. The power spectral density (PSD) feature was computed using 8
hand-selected frequency bands similar to those selected by Alvarez et al.14. These bands were chosen by analyzing
the PSDs of cough vs non-cough signals and selecting the frequency ranges with the highest variation between
the two classes.
We developed an eXtreme Gradient Boosting (XGB)15 classifier to perform the cough classification based on
audio features. In order to assess the performance of the model across various sets of testing and training partic-
ipants, we employed a nested k-fold cross-validation (CV) procedure16. First, the dataset was partitioned into 10
segments, each with an equal number of recordings, hereinafter known as the “outer CV folds”. In each outer fold,
one segment was used for testing and the rest were used for training. Then, within each outer CV fold, the XGB
hyperparameters were tuned using Tree-structured Parzen Estimators (TPE)17. TPE works by further partitioning
the training data into 10 segments, known as the “inner CV folds”, and then determining which set of hyperpa-
rameters exhibits the highest mean precision across the 10 folds. Following each TPE procedure, we tested the
tuned XGB model using the testing data of its respective outer CV fold and computed several accuracy metrics.
We then averaged each accuracy metric across the 10 outer CV folds and recorded its mean and standard devia-
tion, as displayed in Table 3. We can see that this cough classifier exhibits a mean AUC of 96.4% and a standard
deviation of only 3.3%, indicating that the model performs well and shows little variance among different testing
groups. To develop a final, usable model to share with the research community, we reassembled the entire dataset
and randomly selected 22% of the recordings for assessing the generalization capabilities of our model to unseen
test participants. The remainig 78% of the data was used to train the final XGB classifier and determine one final
set of hyperparameters using the aforementioned TPE cross-validation procedure, this time using a 5-fold ran-
dom permutation-based ShuffleSplit CV18.
The ROC curve of the cough classifier, which shows the mean true positive rate versus the mean false positive
rate of the testing results across the 10 outer CV folds, is displayed in Fig. 1. Users of the COUGHVID database
can consult this figure to set a cough detection threshold that suits their specifications. We recommend using a
cough_detected value of 0.8 because, as shown in Fig. 1 and in Table 3, this threshold exhibits an average
precision of 95.4%. Therefore, only 4.6% of recordings with a cough_detected probability greater than 0.8
Fig. 1 Averaged receiver operating characteristic curve across the 10 cross-validation folds of the cough classifier.
can be expected to contain non-cough events, which is not a large enough portion of the dataset to significantly
bias cough classification algorithms. Similarly, the final model exhibits a precision of 95.5% and sensitivity of
80.8%, indicating that the model successfully removes most non-cough recordings while maintaining over 80% of
recordings that truly contain coughs. Finally, the samples confirmed by experts to contain coughs have a cough_
detected value of 1.0, whereas those that experts noted did not contain coughs (less than 3% of the annotated
data) have a cough_detected value of 0.
Expert annotation. To enhance the quality of the dataset with clinically validated information, we were
assisted by four expert physicians. Each of them revised 1000 recordings, selecting one of the predefined options
to each of the following 10 items:
As a labeling support tool, we used an online spreadsheet using Google Sheets©. Thus, the experts could play
the recordings directly inside the browser and select their answers in a convenient way. Once a recording had
been labeled, the background color of the full row turned to green for easier navigation. The time required for
each expert for labeling the 1000 recordings was around 10 hours, without significant differences among the four
experts.
In addition to the personal spreadsheets, the experts were provided with the following general instructions:
• For binary variables (Columns E-J) the box should be ticked for any reasonable suspicion of the sounds being
heard.
• In Column K (“Impression: I think this patient has…”), you should check what you consider the most likely diag-
nosis, knowing that the records were collected between 01/04/2020 and 01/12/2020.
• Each row is automatically marked as “completed” after providing an answer to column K (question number 9).
However, please try to give an answer to every column.
Also, the following criteria for assessing quality was indicated to the experts:
The selection of the recordings to be labeled was done through stratified random sampling and after pre-filtering
using the automatic cough classifier described above, requiring a minimum probability of 0.8 of containing cough
sounds. The distribution of recordings labeled by each expert was based on the self-reported status variable,
as follows:
This stratification ensured that between the four experts, 100% of the recordings labeled as COVID-19 by
users that have a cough_detected value above 0.8 were labeled by at least one expert. Finally, we ensured that
15% of the recordings were labeled by all three reviewers, so that we could assess the level of agreement among
them.
Ethical compliance. All of the data collection and annotation was done in compliance with relevant ethical
regulations. Informed consent was obtained by all participants who uploaded their cough sounds and metadata
to our servers.
Data Records
All of the publicly-available data records are stored on a Zenodo repository19. Considering the recordings with a
cough_detected value greater than 0.8, as explained in the Database Cleaning section, the database consists
of nearly 35 hours of audio samples. This corresponds to approximately 37,000 segmented coughs, as determined
using the segmentation procedure described in the Recording Quality Estimation subsection. Each cough record-
ing consists of two files with the same name but different extensions. One of the files contains the audio data, as
it was directly received at the COUGHVID servers, and it can be in the WEBM20 or OGG21 formats, respectively
with the .webm and .ogg extensions. In all cases, the audio codec is Opus22, with a sampling frequency of 48 kHz
and operating in variable bitrate (VBR) mode. For more than 40% of the recordings, the effective bitrate is 48
kbit/s, which is in the highest bandwidth range for mono recordings22. For the rest of the recordings, the reason
for having a lower effective bitrate is the presence of long periods of silence, which is in fact desirable given the
application. The second file contains the metadata encoded as plain text in the JSON format23, and has the .json
extension. The file name is a random string generated according to the UUID V4 protocol24.
In the metadata we may distinguish three types of variables, related to: (1) context information (timestamp
and the probability that the recording actually contains cough sounds), (2) self-reported information provided
by the user, and (3) the labels provided by expert medical annotators about the clinical assessment of the cough
recording. The only processing performed on the metadata was the reduction in the precision of the geolocation
coordinates to just one decimal digit to ensure privacy protection. A full description of all the metadata variables
is provided in Tables 1 and 4.
As an illustrative example, let us consider the recording with UUID 4e47612c-6c09-4580-a9b6-
2eb6bf2ab40c depicted in Box 1. We can see the audio properties using a tool such as ffprobe (included in
the ffmpeg software package25), while the metadata can be directly displayed as a text file.
Box 1
4e47612c-6c09-4580-a9b6-2eb6bf2ab40c.webm
Input #0, matroska,webm, from ‘4e47612c-6c09-4580-a9b6-2eb6bf2ab40c.
webm’:
Metadata:
encoder: Chrome
Duration: N/A, start: 0.000000, bitrate: N/A
Stream #0:0(eng): Audio: opus, 48000 Hz, mono, fltp (default)
4e47612c-6c09-4580-a9b6-2eb6bf2ab40c.json
{
“datetime”: “2020-04-10T10:30:31.576207 + 00:00”,
“cough_detected”: “0.9466”,
“age”: “50”,
“gender”: “male”,
“respiratory_condition”: “True”,
“fever_muscle_pain”: “False”,
“status”: “COVID-19”,
“expert_labels_1”: {
“quality”: “ok”,
“cough_type”: “dry”,
“dyspnea”: “False”,
“wheezing”: “False”,
“stridor”: “False”,
“choking”: “False”,
“congestion”: “False”,
“nothing”: “True”,
“diagnosis”: “COVID-19”,
“severity”: “mild”
}
{
For convenience, a file compiling all of the available metadata is also provided. This file is named metadata_
compiled.csv, and is a CSV file with 51 columns and one row per record. The first column corresponds to the
UUID of each recording, and may be used as an index, while the rest of the columns correspond to the variables
described in Tables 1 and 4, plus the SNR column described below in the “Recording Quality Estimation” section.
The expert annotation variables have been expanded, and are named quality_1, cough_type_1 … diag-
nosis_4, severity_4.
Technical Validation
Demographic representativeness. An important requirement for large datasets is that they must repre-
sent a wide range of participant demographics. Demographic statistics were collected across all recordings in our
public dataset that provided metadata and that were classified as coughs with a probability above 0.8 by the XGB
cough detection model. There were slightly more male participants than female (66.0% and 33.5%, respectively),
and the majority of participants did not have pre-existing respiratory conditions (83.6%). The percentages of
healthy, COVID-19 symptomatic, and COVID-19 positive participants were 78%, 16.1%, and 5.8%, respectively.
The average age of the recordings was 36.5 years with a standard deviation of 13.9 years. This shows that a wide
variety of ages, genders, and health statuses are captured within our dataset.
Geographic representativeness. In order to assess the plausibility that samples labeled as COVID-19
truly originated from people who tested positive for the disease, we analyzed the geographic locations of the sam-
ples in our public dataset for which this information was provided. We then evaluated the COVID-19 statistics
of the countries at the time each recording was sent to determine if these countries had high infection rates at the
time of recording. Of the 14,787 samples that the XGB model classified as cough sounds, 8887 of them provided
GPS information, 1014 of which reported COVID-19 symptoms and 410 claim to have been diagnosed with
COVID-19. An analysis of this geodata revealed that our dataset contains recordings originating from 125 unique
countries, reflecting the diversity of the dataset.
Studies have shown that coughing persists in a significant proportion of COVID-19 cases 14-21 days after
receiving a positive PCR test26. Therefore, we combined the World Health Organization’s statistics on daily new
COVID-19 cases1 with the United Nations 2019 population database27 to determine the rate of new infections
in the country from which each recording originated in the 14 days prior to it being uploaded to our web server.
This analysis revealed that 94.9% of our recordings labeled as COVID-19 came from countries with more than 20
newly-confirmed COVID-19 cases per 1 million people. Similarly, 93.1% of recordings labeled as symptomatic
originated from these countries.
Fig. 2 Cumulative COVID-19 cases in April and May 2020 per 1 million population, along with the GPS
coordinates of the received recordings.
Figure 2 shows a map of the world with countries color coded according to the cumulative COVID-19 positive
tests in April and May 2020 per 1 million population. We also show the COVID-19 and symptomatic recordings
in our public corpus providing GPS information that were collected within this time period. This figure shows
that most recordings were sent from countries with moderate-to-high COVID-19 infection rates at the time.
Inter-rater reliability. In order to determine the extent to which the four expert physicians agreed on their
cough sound labeling, Fleiss’ Kappa scores28, KFleiss, were computed for each question among the 130 common
recordings in the public dataset. KFleiss is a standard method for gauging the consistency of categorical labels across
multiple reviewers. This measure ranges from −1 – indicating no agreement among any reviewers – to 1, corre-
sponding to perfect agreement among all reviewers. The results are displayed in Table 5, which depicts the KFleiss
measures along with the strength of agreement according to the benchmark scale proposed by Landis and Koch29.
This analysis revealed moderate agreement on audible nasal congestion, fair agreement on the type of cough, as
well as slight agreement on the cough severity, nothing specific, audible wheezing, and diagnosis.
There was a slight agreement among experts on the cough diagnosis (KFleiss = 0.07), which is reflective of the
fact that COVID-19 symptomology includes symptoms of both upper respiratory tract infections (e.g., rhinor-
rhea, sore throat, etc.) and lower respiratory tract infections (e.g., pneumonia, ground-glass opacities, etc.)30.
When the expert labels that are not “COVID-19” or “healthy cough” are changed to “other”, the agreement slightly
increases (KFleiss = 0.08). To determine the commonalities in labels between individual experts, we computed KFleiss
on the cough diagnoses of pairs of experts. There was a fair agreement between Experts 3 and 4 (KFleiss = 0.22),
a slight agreement between Experts 1 and 4 (KFleiss = 0.04), and a slight agreement between Experts 1 and 2
(KFleiss = 0.07). Other pairs of experts exhibited poor agreement. While a lack of a clear diagnostic consensus
between all experts is to be expected for a novel pathology, it is advisable that users take this into consideration
when using the experts’ labels as ground-truth.
Trends in expert COVID-19 cough labeling. All of the coughs in the public database that were labeled as
COVID-19 among the four experts were subsequently pooled together and analyzed for trends in the attributes of
the cough recordings. The vast majority of coughs do not exhibit audible dyspnea (93.72%), wheezing (92.43%),
stridor (98.71%), choking (99.20%), or nasal congestion (99.03%). Additionally, 86.96% of COVID-19-labeled
Fig. 3 Histogram of estimated SNRs of every recording in the database with a cough_detected value greater
than 0.8.
coughs are annotated as dry, which is consistent with literature stating that a dry cough is a common COVID-19
symptom5,30. Finally, 83.58% of these coughs are labeled as mild. These commonalities among COVID-19 labeled
coughs reflect the consistency of the database.
Recording quality estimation. Every user who uploaded their cough sound to the COUGHVID dataset
presumably used a different device, potentially introducing a variation in recording quality due to the different
recording hardware and software of each device. Furthermore, the recordings were captured at various locations
around the world with non-constant degrees of background noise. In order to assist users of the COUGHVID
dataset in estimating the quality of each signal, we provide open-sourced code to estimate the Signal-to-Noise
Ratio (SNR) of each cough recording.
The SNR estimation method begins with a simple cough segmentation algorithm based on a digital hysteresis
comparator on the signal power. The signal is first normalized to the [−1, 1] range, lowpass filtered (fcutoff = 6 kHz),
and downsampled to 12 kHz. Then, the hysteresis comparator identifies regions of the signal with rapid spikes
in power, which is customary for cough sounds. Since the expiratory phase of the cough lasts 230-550 ms31, we
discard any cough sounds lasting less than 200 ms. Furthermore, we consider the 200 ms before and after a cough
sound as part of the cough, as this period may comprise the low-amplitude compressive and expiratory phases of
the cough sound31. Following the cough segmentation, the SNR is computed as following Eq. 1,
1
∑
|xcough| x (n)εxcough
x(n)2
SNR = 20 × log10
2
x(n)
1
∑
|xnoise| x (n)εxnoise
(1)
where xcough are the signal samples determined through segmentation to be part of a cough, and xnoise are all other
signal samples, presumed to be background noise. Intuitively, this formula compares the signal power of the cough
portion of the signal to that of the background noise. This SNR information is included under the SNR column of the
recording metadata CSV file. A histogram of all SNR values for recordings with a cough_detected probability
greater than 0.8 is shown in Fig. 3, showing a wider variety of signal qualities present in the dataset. Users of the data-
base may employ these computed SNR values to filter the dataset by maintaining only recordings of a desired quality.
Code availability
The aforementioned XGB classifier used to remove non-cough recordings, feature extraction source code, cough
preprocessing methods, cough segmentation function, and SNR estimation algorithm are available on our public
repository.
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Acknowledgements
This work has been supported in part by the DeepHealth Project (GA No. 825111), and in part by the Swiss NSF
ML-Edge Project (GA No. 182009). We would also like to acknowledge Dr. Constantin Bondolfi, Dr. Pierre-Yves
Ryser Dr. Erin Gonvers, and Dr. Alain Sauty for their hard work in the manual annotation of the recordings, and
also Dr. Mary-Anne Hartley from Unisanté (Centre Universitaire de Médecine Générale et Santé Publique á
Lausanne) for providing us with the guidelines for data acquisition and the definition of the annotation protocol.
Author contributions
L.O. and T.T. devised the idea and research. L.O. developed the cough signal processing code, created the cough
detection model, and performed data analysis on the user metadata and expert labels. T.T. deployed and managed
the data collection website, coordinated expert labeling, and compiled all of the metadata. All authors contributed
to the writing and editing of the manuscript.
Competing interests
The authors declare no competing interests.
Additional information
Correspondence and requests for materials should be addressed to L.O.
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