HONG KONG – Whether bats are the source of COVID-19 is a debatable point; however, using sound to navigate like them could prove key for diagnostics and disease monitoring.

To that end, Nesher, Israel-based Bat-Call Ltd. is using its auscultation technology in the battle against the pandemic. It said its patented artificial intelligence (AI) infra-sound analysis and deep learning classification technologies can support the early detection and monitoring of COVID-19 patients.

“Unlike regular stethoscopes, our device detects both body sounds and body infra-sounds. It is the only device in the world that analyzes body infra-sounds – clinical data that is not used by the medical community,” Doron Adler, the CEO and co-founder of Bat-Call, told BioWorld.

“Our system operates [like] a regular stethoscope. You simply place it over the patient's lungs (over the clothes). The system picks up the sounds, analyzes them in real time using AI and machine learning algorithms, and, based on the classifier we have, it can help determine if the patient has COVID-19, and in which state.”

Although listening to the sounds of the body remains a key component in diagnosis, doing so by using traditional stethoscopes is highly subjective, relying on the examiner's auditory skills.

Inaccurate auscultation can result in suboptimal care, unnecessary exams and increased health care costs, according to Bat-Call. It claims that its classification algorithm has achieved 90% detection accuracy for pneumonia patients, compared with the average of 55% with traditional auscultation.

The company is adapting its classifier of sounds from pneumonia detection and monitoring to COVID-19, due to the similarities between the two.

“We are already collecting COVID-19 patients' lung sounds, and we believe that in a matter of few weeks, we will have our classifier ready to use. With the current situation, we expect to get expedited approvals,” said Adler. “Our flagship product, the Compusteth, is the system we are currently ... modifying to support with COVID-19 detection.”

Lung sounds

"A technology that can monitor low frequencies of lung sounds can better detect and monitor deterioration or improvement of the disease,” said Amin Shneifi, head of the emergency department at the Emek Medical Center in Israel.

Shneifi noted that the center is collecting the lung sounds of patients coming to the emergency room with potential COVID-19, as well as from diagnosed patients in its coronavirus ward.

“As more medical centers are expected to take part in this project, and with the data collected, the company's classifying algorithm could create a predictive tool to facilitate diagnosis and monitoring," said Shneifi.

The company wants to use the data and its tech for screening on a wide scale.

"Bat-Call's technology can potentially be harnessed for effective and rapid mass screening[,] ... as well as accurate diagnosis and monitoring of quarantined COVID-19 patients without medical personnel on site, as the device classifier can indicate the state of the condition, and if needed, transmit it remotely,” said Yitzhack Schwartz, chief medical officer of Bat-Call.

The company believes this will reduce unnecessary X-rays, CT scans and blood tests, thus lowering referrals to medical centers and keeping staff safe from infection.

“The growing need for digital health care solutions, together with self-assessment monitoring and tele-medicine features, are now highlighted and needed more than ever with the outbreak of the COVID-19," said Schwartz.

Israel first

“Because we are an Israeli company, we will launch it here first, followed by the EU and U.S. We are working with a global partner that is a leader in developing and selling primary care diagnostic systems, and they are interested in being our worldwide partner,” said Adler, who did not disclose the group's identity.

As of now, Bat-Call’s acoustic digital diagnostic systems are being used to help in the early diagnosis and management of a host of chronic diseases, such as asthma.

“We also have classifiers for pneumonia, aortic stenosis, congestive heart failure, chronic obstructive pulmonary disease … and other pulmonary conditions,” said Adler.

Founded in 2016, the company has three product lines.

The first is the Voqx, a smart auscultation device that is teamed with an AI-based classifier. It provides comprehensive clinical information from its integrated sensors, which measure pulse, oxygen saturation, respiratory cycle and body temperature.

Next is the Pyx, a compact self-assessment device for severe chronic cardiac and respiratory disease patients in constant need of home monitoring.

Finally, the Acoustic Imaging System (AIS) provides 3D mapping using chest sounds, highlighting abnormalities. AIS aims to enable speedy and accurate triage in medical centers.