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With the recent outbreak of COVID-19, ultrasound is fast becoming an inevitable diagnostic tool for regular and continuous monitoring of the lung. However, lung ultrasound (LUS) is unique in the perspective that, the artefacts created by acoustic wave propagation is aiding clinicians in diagnosis. In this work, a novel approach is presented to extract acoustic wave propagation driven features such as acoustic shadows, local phase-based feature symmetry, and integrated backscattering to automatically detect the pleura and to aid a pretrained neural network to classify the severity of lung infection based on the region below pleura. A detailed analysis of the proposed approach on LUS images over the infection to full recovery period of ten confirmed COVID-19 subjects across 400 videos shows an average five-fold crossvalidation accuracy, sensitivity, and specificity of 97%, 92%, and 98% respectively over randomly selected 5000 frames. The results and analysis show that, when the input dataset is limited and diverse as in the case of COVID-19 pandemic, an aided effort of combining acoustic propagation-based features along with the gray scale images, as proposed in this work, improves the performance of the neural network significantly even when tested against a completely new data acquisition.

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