Deep Learning Approach to Detect

the Covid-19 Infection Using Chest X-ray

Image: A Review

Triwiyanto Triwiyanto, Lusiana, Levana Forra Wakidi, and Farid Amrinsani

Abstract The COVID 2019 outbreak has been designated by WHO as a pandemic
since 2020. Various methods of diagnosis of COVID 19 have been developed by
several researchers to cope with COVID 19. A proper and accurate diagnosis is
crucial for the next treatment step. Deep learning has been widely applied in the
image classification process with high accuracy. However, the selection of the right
deep learning model for the detection of lung disorders caused by COVID-19 based
on x-ray images of the chest has not been widely reviewed by several reference
sources. Therefore, the purpose of this study is to do a paper review that reviews a
deep learning approach to detect COVID 19 through chest X-ray images. The refer-
ence sources used in the preparation of this review paper are from various databases
such as PubMed, IEEE-explore, and ScienceDirect in the period of 2020–2021. The
results of the review and discussion show that deep learning with the convolution
neural network (CNN) algorithm is more widely applied in the process of recog-
nizing patterns of lung abnormalities caused by COVID 19. However, deep learning
with transfer learning has the potential for better accuracy because it applies the
architecture that has been used to solve the same previous problem. The conclusion
that can be drawn from this study is that CNN is still the right method for diagnosing
lung disorders caused by COVID 10 compared to conventional machine learning.

Keywords COVID 19 · Chest X-ray · Deep learning · CNN

1 Introduction

In 2020, WHO has determined that the corona virus disease 19 (COVID 19) outbreak
is a pandemic disease [1]. At the time this article was written, the COVID-19 outbreak
had caused 200,518,280 people to be infected and 4,250,000 people died worldwide.
The COVID-19 virus is a new variant of SARS that attacks the respiratory tract, espe-
cially the lungs. The pre-diagnosis of someone being infected with the COVID-19

T. Triwiyanto (B) · Lusiana · L. F. Wakidi · F. Amrinsani

Poltekkes Kemenkes Surabaya, Jl. Pucang Jajar Tengah No. 56, Surabaya 60282, Indonesia
e-mail: triwi@poltekkesdepkes-sby.ac.id

© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022 237
T. Triwiyanto et al. (eds.), Proceedings of the 2nd International Conference
on Electronics, Biomedical Engineering, and Health Informatics, Lecture Notes
in Electrical Engineering 898, https://doi.org/10.1007/978-981-19-1804-9_19
238 T. Triwiyanto et al.

virus is having a high fever, decreased sense of taste and sense of smell, experiencing
a prolonged dry cough, and experiencing shortness of breath. Currently, the diag-
nostic process to detect whether a person is positively infected by the COVID-19
virus is carried out in three ways, using viral, blood, and chest X-ray image methods
[2, 3]. Meanwhile, the examination of COVID 19 using the blood method or known
as the Antigen method, is through a reagent reaction with a sample of the blood
of a patient suspected of being infected with COVID 19. Actually, the examination
of COVID 19 using the blood method is to detect COVID 19 indirectly, namely
by seeing whether there is the formation of antibodies through the patient’s blood
sample. This is due to the human body; when it is infected with a virus, can naturally
produce antibodies, causing the examination using the blood method to be less accu-
rate. The diagnosis of COVID 19 using the viral method is taking samples from the
nose or throat. This method is also known as a rapid test through the examination of
antigens. Another alternative, viral examination of specimens, is to use polymerase
chain reaction (PCR) [4]. However, to get accurate results, the examination using
PCR must be carried out repeatedly within 14 days for patients who have indications
with COVID 19 symptoms by using X-ray images which can be done for diagnostic
purposes. Examination of chest X-rays must be done by an expert to determine lung
disorders or abnormalities. Manual chest X-ray examination requires a high level
of time and expertise, so as an alternative to the development of the COVID-19
identification process in the lungs, it can be done using machine learning.
Machine learning is an algorithm that is embedded in a computer machine in
such a way that the machine is able to learn and make decisions like humans [5].
In general, machine learning is built using three basic components, namely, pre-
processing, processing, and post-processing [6]. Pre-processing is the most important
part of machine learning, including processing, thresholding, scaling, and feature
extraction. Several conventional machine learnings have been used to help diagnose
COVID 19 through chest X-ray images, including artificial neural network, support
vector machines, and linear discriminant analysis. In conventional machine learning,
it requires a feature extraction process before processing so that the accuracy of
the system depends on the choice of the feature extraction model used [6]. Feature
extraction models that are often used are time, frequency, and team-frequency domain
features. Furthermore, in the last decade, machine learning has experienced very
significant developments, especially in the pre-processing and architecture sections,
namely deep learning. Several researchers have developed deep learning using the
convolution neural network (CNN) algorithm [2, 7, 8], which has advantages in terms
of pre-processing, namely, it has learning features through the convolution process
[9] so that the deep learning model that uses the CNN algorithm does not require
pre-processing in the form of feature extraction.
Several researchers have applied deep learning for the purposes of X-ray image
classification to detect abnormalities in an object, such as cancer in organs, diabetes
mellitus through the retina of the eye, disorders of the lungs and other medical
illnesses [10–14]. During the COVID-19 pandemic, deep learning has been devel-
oped by several previous researchers to assist doctors in the diagnosis process, espe-
cially through chest X-ray images. COVID 19 attacks the respiratory tract, especially
Deep Learning Approach to Detect the Covid-19 Infection … 239

the lungs, which can be clearly seen by the symptoms of the patient experiencing
shortness of breath. Shortness of breath is due to bronchial cells in the lungs have
been infected by the virus and inhibit the lungs in producing oxygen for the blood. In
the X-ray photo, it will be seen visually the part of the lung infected with COVID 19
with the result in the form of clouding in the image section. Deep learning methods
have enormous potential to be applied to various applications, especially helping
doctors in diagnosing COVID 19 in patients. Therefore, this article aims to clearly
and completely review the Deep learning approach in helping the process of diag-
nosing patients experiencing symptoms caused by COVID 19 through chest X-ray
images.
This article is expected to be able to contribute to researchers who are developing
COVID-19 detection using chest X-ray images, namely architectural models and
appropriate hyper parameters, in the application of deep learning. Furthermore, in
this article, readers can find reliable sources of datasets so that they can be used for
development purposes. Overall, the rest of the discussion of this article consists of a
background section that discusses related to deep learning, and the Review Section
reveals previous studies related to the diagnosis of COVID 19 based on chest X-ray
images. The results and discussion section discusses the results of the review, and
finally, the conclusion section concludes the results of the article review.

2 Deep Learning Method

The artificial neural network was first introduced in 1943 by Warren McCulloch,
which is a network that imitates the working system of human brain cells that have
the ability to learn new things. Basically, a neural network is composed of three main
layers, namely, the input layer, the hidden layer, and the output layer. Each layer is
composed of several neurons that will be active. Activation of each neuron can use
sigmoid activation or other activation. In the development of artificial neural network
research, the architecture of the artificial network has developed from one hidden
layer to multilayer, hereinafter known as deep learning. Figure 2 shows examples of
deep learning architectures used to recognize patterns in an image. The architecture
shows six hidden layers, one input layer and one output layer. In order to prevent over
fitting during the training process, the number of nodes in the hidden layer can be
reduced by using the dropout function (5–90% of the total nodes in one layer). The
number of hidden layers can be determined based on the complexity of the patterns
that will be recognized by the network.
In general, the process of recognizing an image is shown in Fig. 2, which consists
of pre-processing, segmentation, feature extraction, and machine learning. At the
pre-processing stage, it can be in the form of stages, among others, thresholding,
scaling, filtering, and morphological opening. The feature extraction stage can be
carried out using time, frequency, and time–frequency domains, and this depends on
the needs and complexity of the image patterns to be recognized. Feature extraction
240 T. Triwiyanto et al.

in the time domain, for example, mean, standard deviation, kurtosis, etc., is often
used because it has a very fast calculation process compared to other feature domains.
The deep learning architecture shown in Fig. 2 is the development of an artificial
neural network architecture model with more than one hidden layer; in this case, there
are six hidden layers. In the deep learning model, as illustrated in Fig. 1, the model
still requires pre-processing, segmentation, and feature extraction stages. However,
the weakness of the deep learning model with the architecture, as shown in Fig. 1,
is that the model still uses feature engineering to extract the learned input patterns.
Feature engineering must be selected, combined, and tested, which results in the
highest machine learning accuracy, so this requires more time and effort. In order to
improve the model, the next deep learning development is an artificial neural network
model that has feature learning so that the model can perform the feature extraction
process without using feature engineering (for example, time, frequency, and time–
frequency domain). In this case, the feature learning process is carried out using a
convolution process between the images to be recognized by a filter or commonly
referred to as the kernel.
The basic concept of feature learning is to find the dominant features in the image
by utilizing the convolution process between the image and the filter (kernel). Kernel
weight at the beginning is randomly generated. Kernel dimensions are generally
chosen based on experimentation with the indicators that yield the highest accuracy.
An example of a two-dimensional (2D) convolution process between a 7 × 7 image
and a 3 × 3 two-dimensional kernel is shown in Fig. 3. The 3 × 3 kernel will
be convoluted with a 7 × 7 image successively from column 1 to column 5. Each
convolution image and kernel return one value. The convolution process between
image (I) and kernel (K) runs sequentially from the 1st column to the 5th column
with 1 column overlap from left to right. Thus, the final result of the convolution
produces a new matrix with a size of 5 × 5 (I*K). The result of this convolution
process is referred to as a feature map.
In addition to the convolution process, to reduce noise in a feature map, a max-
pooling process can be applied. The max-pooling process, as shown in Fig. 4, will
select the maximum values in the feature map in the matrix so as to produce a feature
map with the new matrix dimensions. This process is similar to the convolution

Preprocessing
Image Dataset Segmentation
Image

Feature Machine Output

Extraction Learning classification

Fig. 1 Standard image processing using machine learning

Deep Learning Approach to Detect the Covid-19 Infection … 241

Dropout

Hidden Layer 1 Hidden Layer 2 Hidden Layer 3 Hidden Layer 4 Hidden Layer 5 Hidden Layer 6 Output Layer
Input Layer 100 nodes 100 nodes 100 nodes 100 nodes 100 nodes 50 nodes 6 nodes
ReLU ReLU ReLU ReLU ReLU ReLU Sigmoid

Feature
Segmentation Pre-processing Image Dataset
Extraction

Fig. 2 Introduction of image pattern using deep learning

0 1 1 1 0 0 0
0 0 1 1 1 0 0
0 0 0 1 1 1 0 1 4 3 4 1

0 0 0 1 1 0 0 1 2 4 3 3

0 0 1 1 0 0 0 1 0 1 1 2 3 4 1

0 1 1 0 0 0 0 0 1 0 1 3 3 1 1

1 1 0 0 0 0 0 1 0 1 3 3 1 1 0

Image 2D: 7x7 Kernel 2D: 3x3 Convolu on 2D: 5x5

Fig. 3 Convolution image and kernel

process, but there is no overlap between cells, and there is no multiplication and
matrix addition process between the kernel and image.
Deep learning with feature learning using a convolution algorithm, hereinafter
referred to as a convolution neural network (CNN). Deep learning using the CNN
algorithm has been applied in various kinds of research, especially image and signal
242 T. Triwiyanto et al.

Fig. 4 Proses max-pooling

feature map 6 × 6 21 12 15 9 10 12 3x3 30 17
30 23 27 17 6 8 MAX Pooling 13 18

18 19 24 5 4 9
2 7 8 1 6 8
11 13 10 9 10 13
9 8 7 15 11 18

pattern recognition. Figure 5 shows an example of a pattern recognition chest X-ray

image to detect lung abnormalities. The object of this research is the images from the
chest X-ray photo. In Fig. 3, the CNN deep learning model is composed of 10 layers
which is a combination of the convolution model and the standard neural network
model. At the front of the CNN, the model is composed of 2 convolutions, two
max-pooling, and flattened layers which are then followed by five fully connected
layers (4 hidden layers and one output layer). In the convolution process, layer 1,
a 32 × 32 two-dimensional image, is convoluted with a 4 × 4 kernel to produce a
two-dimensional feature map with a feature map size of 28 × 28. In the 2nd layer,

2D: 30 x 30 2D: 28 x 28
2D Convolution layer Max pooling
Layer 1 (L1) Layer 2 (L2)

Kernal: 4x4

..
...
... ...
... ...
...
...
...
... .
...
...

2D: 32 x 32

.. .
... ..
... ...
... ...
... ... Output
... nodes
...
..
.
. 50 50 20
2D: 24 x 24 2D: 8 x 8 2D: 8 x 8 nodes nodes nodes
2D Convolution layer 2D: Max pooling 1D: Flattened
Layer 3 (L3) Layer 4 (L4) Layer 5 (L5) Fully connected layer

Fig. 5 Recognition of abnormal image patterns in the lungs using CNN-based deep learning
Deep Learning Approach to Detect the Covid-19 Infection … 243

the result of the 1st layer feature map will go through the max-pooling layer. The
max-pooling process will reduce the number of previous feature maps.
The final stage of a feature learning process (Fig. 4) is the flattened layer process,
which is the process of changing a 2-dimensional matrix into an N × 1 one-
dimensional matrix, which then forms a hidden layer. In the next stage, the deep
learning model with CNN consists of a conventional artificial neural network struc-
ture, which consists of several hidden layers and an output layer. The selection of the
number of output layer nodes is determined by the number of classes in the devel-
oped model. In the next section, we review the studies that have been carried out by
previous researchers in applying machine learning in more detail for the purposes of
diagnosing COVID 19 based on X-rays.

3 Materials and Method

The research materials were taken from various reference sources such as PubMed,
IEEE-explore, and ScienceDirect databases. The focus materials taken as material
for making this review paper are those related to the diagnosis of COVID-19 based
on x-ray images using a deep learning approach. The references we used to compile
review papers are articles published from 2020 until now (July 2021). The keywords
for searching in the database are deep learning, covid-19, and x-ray images. To
perform keyword bibliographic analysis, we used the VosViewer application with
clustering results, as shown in Fig. 6.
The analysis results showed that the proposed keywords based on the reference
source database were grouped into four major groups, namely COVID-19/Deep
learning, tomography, human and male clusters. The results of the VOSviewer (Fig. 5)
show that each cluster contains the x-ray keyword. In more detail, the keywords for
each cluster are shown in Table 1, which consists of four clusters, namely clusters 1,
2, 3, and 4, each of which is shown in red, blue, green, and yellow.

4 Review

In this study, we reviewed 41 articles that focused on deep learning methods to detect
Covid-19 using chest X-rays images. The reference for this research is articles from
2020 to 2021, using a deep learning classifier with several algorithms, including
CNN, DNN, Transfer Learning, and several other algorithms. Generally, in order
to classify the image, the deep learning classifier follows several steps, including
pre-processing, segmentation, feature learning, classification, and prediction. The
feature learning was done by performing the convolution process between the image
and kernel. The convolution process was done in two dimensional.
Table 2 shows the summary of several studies that have studied the classifica-
tion of the COVID-19 images based on deep learning with the CNN algorithm. In
244 T. Triwiyanto et al.

Fig. 6 Bibliographic analysis of deep learning approach for COVID 19 detection using chest X-ray
images

Table 1 Clustering bibliographic based on deep learning, covid-19, and x-ray image keywords
Cluster Keywords Colors
1 Artificial intelligence, chest CT, chest x-ray, classification CNN, computed Red
tomography, computer-aided diagnosis, coronavirus, covid-19, covid-19
detection, deep learning, feature extraction, image classification, machine
learning, medical imaging, pandemic, radiology, segmentation, transfer
learning, x-ray, x-ray images
2 Adolescent, adult, aged, aged 80 and over, area under curve disease prognosis, Blue
female, Italy, male, middle aged, prognosis, radiography, radiologist,
retrospective studies, severity of illness index, thorax, young adult
3 Chest x-ray, algorithm, chine, computer simulation, covid-19 testing, Green
databases, factual, human, image interpretation, image Processing, neural
network, pneumonia, radiography, thoracic, reproducibility of result, roc curve
sensitivity and specificity, x-rays
4 Artificial intelligence, covid-19, deep learning, machine learning, transfer Yellow
learning, datasets as topic, diagnosis, differential early diagnosis, lung,
pandemics, pneumonia, viral, the predictive value of tests, radiographic image,
sarscov-2, tomography, x-ray
Deep Learning Approach to Detect the Covid-19 Infection … 245

Table 2 Deep learning using CNN algorithm for classification of abnormalities on image x-ray
caused by COVID-19
Authors DL algorithm Results
[2] Pelaez, Enrique, Loayza, Francis CNN Accuracy: 98.2%
et al. (2020)
[15] Saddam Bekhet et al. (2020) CNN Accuracy: 96%
[16] Julian D. Arias-Londono et al. CNN Accuracy: 91.5%
(2020)
[17] T. Padma et al. (2020) CNN Accuracy: 99%
[9] Asma Channa et al. (2020) CNN Accuracy: 91.67%
[18] Joaquim De Moura et al. (2020) CNN Accuracy: 90.27%
[19] Rachna Sethi et al. (2020) CNN Accuracy: 99%
[20] Malaya Kumar et al. (2020) CNN Accuracy: 99.68%
[7] Areej et al. (2021) CNN Accuracy: 91.67%
[21] Sohaib Asif et al. (2021) CNN Accuracy: >98%
[22] Abhishek Panwar et al. (2021) CNN Accuracy: 98%
[23] Zehra Karhan et al. (2021) CNN Accuracy: 99.5%
[24] Shivani Sharma et al. (2021) CNN Accuracy: 94%
[25] Raghav Kandhari et al. (2021) CNN Accuracy: 98.9%
[26] Emrah Irmak. (2021) CNN Accuracy: 99.20%
[27] Nayeeb Rashid et al. (2021) CNN Accuracy: 96:33%
[28] Samira Lafraxo et al. (2021) CNN Accuracy
Binary Classification: 94%
Multi-class classification: 5.77%
[1] Mohammed Seghir et al. (2021) CNN Precision: 98.9%
[29] Ahmed Mabrouk et al. (2021) CNN-XGB Normal, pneumonia, and COVID-19
[30] Hanan S. Alghamdi et al. (2021) CNN Diagnosis of COVID-19 via CXR
images
[31] Sabrina Nefoussi et al. (2021) CNN Normal, pneumonia, and COVID-19
[4] Mehmet Sevi et al. (2021) CNN COVID-19, viral pneumonia, and
healthy patients
[32] Naveen Paluru et al. (2021) CNN Abnormal and normal regions

summary, the number of classes used in this study range between two and four classes.
In the two classes classification, deep learning classified the lung x-ray images in
normal condition or infected by COVID-19. Furthermore, in the four classes classi-
fication, the authors classified the x-ray image into normal, pneumonia/COVID-19,
pneumonia/viral, and pneumonia/bacterial infection. Moreover, the accuracy value
of the CNN was obtained in the range of 92–99%, as well as the classification of CT
images for normal, pneumonia, and COVID-19 [19, 19, 19]. CNN also performed a
segmentation stage in which the classes were categorized as normal/abnormal images
of covid-19 [23, 23].
246 T. Triwiyanto et al.

Table 3 describes some of the deep learning methods which used algorithms other
than CNN, including DTL (deep transfer learning), TL (transfer learning), DNN
(deep neural network), K-EfficientNet, EfficientNet, EDL (ensemble deep learning),
Mask RCNN (recurrent CNN), NN (neural network), GAN (generative adversarial
network), and CovAI-Net by using CXR (Chest radiograph).
Several algorithms such as DTL [26], CovAI-Net [28], DNN [32], TL [37], Mask
RCNN (recurrent CNN) [42] performed a classification from CT images which clas-
sified the image into covid-19, normal, pneumonia. Furthermore, the pneumonia
locations could be located with accuracy values ranging from 90 to 99%.

5 Discussion

We have analyzed the keyword bibliographic using VOSviewer. We found that all of
the related keywords were clustered into four clusters. The most dominant keyword
was shown in cluster 1, which is indicated with the red color. In this cluster, it
was shown that COVID-19 and deep learning intersect each other. Another related
keyword that supports this cluster was tomography, medical imaging, x-ray, CNN,
and transfer learning. The second cluster which is indicated with blue color, is more
concerned with discussing the relationship among humans, neural networks, and
algorithms. The third cluster (green color) discussed the relationship between tomog-
raphy, radiologist, and human. The last cluster (yellow color) is related to lung,
COVID-19, x-ray tomography, and deep learning keyword. In this bibliographic
analysis, mostly all of the clusters were interconnected with each other, especially
for clusters one and four. Based on 44 articles that have been reviewed, it can be
concluded that CNN is a deep learning algorithm that performs many classification
methods on CT images through a segmentation process [23, 23]. The DTL (deep
transfer learning) algorithm has successfully detected COVID-19 using CT images
[26]. Some deep learning algorithms such as K-EfficientNet [39], EfficientNet [40],
EDL-COVID [41], and Mask RCNN [42] in detecting covid-19 produce up to 97%
accuracy. Transfer learning is one of the best deep learning algorithms in performing
classification methods because it has a very high accuracy of up to 99.87% [36].
In the present study, the CNN and transfer learning algorithm mostly resulted
in high accuracy values. Several studies developed a deep learning classifier with a
CNN algorithm to classify a number of classes. Furthermore, the authors preferred
to select the CNN algorithm because this deep learning CNN architecture can be
customized according to the complexity of the model. Other studies favor using deep
learning using transfer learning algorithms. The benefit of using a transfer learning
algorithm is that the knowledge from previous learning could be transfer for the
next task. Generally, the authors used the CNN architecture from InceptionnetV3,
ResNet18, ResNet50, SqueezeNet, and DenseNet-121 as the transfer learning for
image classification. Basically, the architecture was developed based on a convolution
neural network.
Deep Learning Approach to Detect the Covid-19 Infection … 247

Table 3 Deep learning based on transfer learning and other algorithms for classification of
abnormalities on image x-ray caused by COVID-19
Author DL algorithm Results
[33] Taki Hasan Rafi et al. DTL Accuracy: 98.43%
(2020)
[34] O. F. Layode et al. DTL Covid-19 and other abnormal
(2020) pulmonary and cardiothoracic
conditions in CXRs
[35] Sanhita Basu et al. DETL Accuracy: 90.13% ± 0.14
(2020)
[36] Mohit Mishra et al. CovAI-Net Non-Pneumonic and
(2020) Pneumonic, Covid-19 Positive
and Covid-19 Negative
[37] Khosro Rezaee et al. DTL level for infectious diseases
(2021) similar to bacterial and viral
pneumonia
[38] Mohammad Mahmudur DNN Accuracy: 96.91%
Rahman Khan et al. (2021)
[39] Yifan Peng et al. (2021) DNN COVID-19 CXR and
COVID-19 CT
[40] Fian Yulio Santoso et al. DNN Normal, pneumonia and
(2021) pneumonia caused by
COVID-19
[41] Yash Chaudhar et al. DNN Accuracy: 95%
(2021)
[42] D. Haritha et al. (2020) TL Accuracy: 99.49%
[43] Stephany Octaviani et al. TL Accuracy: 99.35%
(2021)
[44] Naufal Hilmizen et al. TL Accuracy: 99.87%
(2021)
[45] Nikhil Bhatia et al. TL Healthy, pneumonia, and
(2021) COVID-19
[46] Amina Baseer et al. TL Accuracy: 97.36%
(2021)
[47] Papa Abdou Karim et al. K-EfficientNet Accuracy: 97.3%
(2021)
[48] Talha Anwar et al. EfficientNet Accuracy: 0.897
(2021)
[49] Shanjiang Tang et al. EDL-COVID Accuracy: 95%
(2021)
[50] Junfeng Li et al. (2021) NN Accuracy: 94.1%
[6] Zhaohui Liang et al. generative adversarial network Accuracy: 97.8%
(2021) (GAN)
248 T. Triwiyanto et al.

Based on chest X-ray images, abnormalities in the lungs can be detected based on
differences in color or contrast in the images. Pneumonia, apart from being caused
by COVID-19, can also be caused by another virus known as viral pneumonia. In
addition, pneumonia can be caused by bacterial pathogens or referred to as bacterial
pneumonia. To improve the accuracy of the deep learning classifier, some researchers
only classified images into two classes, namely normal and COVID-19. Furthermore,
some researchers distinguish chest X-ray images into four classes, namely, normal,
COVID-19 pneumonia, viral pneumonia, and bacterial pneumonia.

6 Conclusion

This present study was proposed to review some paper which concern to study the
implementation of the deep learning to detect the infection of the COVID-19 to
the lung using chest x-ray images. A bibliographic analysis using VOSviewer was
applied to obtain the keyword clustering and relationship, among others. From the
analysis, it has been shown that the keyword of deep learning, COVID-19 and x-ray
image was clustered into four groups. From the data collection, we confirmed that the
deep learning based on convolution neural network and transfer learning algorithm
resulted in high accuracy among others in the images classification. Deep learning
with transfer learning (TL) algorithm was the approach that is often used among
others. Generally, authors developed a deep learning approach to classify the images
between 2 and 4 classes. Finally, further review paper could be proposed to classify
the x-ray image chest, which comes from with and without symptoms.

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