Monitoring of prevalent airborne diseases such as COVID-19 characteristically
involves respiratory assessments. While auscultation is a mainstream method for
preliminary screening of disease symptoms, its utility is hampered by the need
for dedicated hospital visits. Remote monitoring based on recordings of
respiratory sounds on portable devices is a promising alternative, which can
assist in early assessment of COVID-19 that primarily affects the lower
respiratory tract. In this study, we introduce a novel deep learning approach
to distinguish patients with COVID-19 from healthy controls given audio
recordings of cough or breathing sounds. The proposed approach leverages a
novel hierarchical spectrogram transformer (HST) on spectrogram representations
of respiratory sounds. HST embodies self-attention mechanisms over local
windows in spectrograms, and window size is progressively grown over model
stages to capture local to global context. HST is compared against
state-of-the-art conventional and deep-learning baselines. Demonstrations on
crowd-sourced multi-national datasets indicate that HST outperforms competing
methods, achieving over 83% area under the receiver operating characteristic
curve (AUC) in detecting COVID-19 cases