Accuracy of Chest Ultrasonography in Diagnosis of COVID 19 Pneumonia

Abstract

Rationale: COVID 19 virus infection is ongoing catastrophic worldwide pandemic with significant morbidity and mortality. Large numbers of persons that getting COVID19 virus infection at high risk of developing COVID 19 pneumonia;with increasing chance of worse and prolonged illness. Early diagnosis of COVID 19 pneumonia, patient care and isolation using simple less expensive image are wanted. Decreasing the numbers of medical and paramedical personnel exposure to COVID 19 patients is always recommended, High resolution CT Chest (HRCT chest) is the Gold standard method to diagnosis COVID 19 pneumonia;however it is expensive with increasing the exposure risk;chest ultrasonography may be alternative method, however still not confirmed. Methods: In consecutive patients referred to assess COVID 19 pneumonia in outpatient pulmonology clinic in Assiut Governorate;between May 2020 and October 2020. Chest ultrasonography was done for patients accepting to participate in the study. HRCT chest to confirm COVID 19 pneumonia were done within 24 hours of Chest ultrasonography exam, the chest ultrasonography operators were blind to HRCT chest results;chest ultrasonography were done by two chest consultants expert in chest ultrasonography at Chest Department of Assiut University Hospital . The chest ultrasonography was done using the convex probe of Aloka and Fukuda ultrasonography devices. The chest Ultrasonography considered positive for pneumonia if the examiners find presence of abnormal multiple vertical B-lines or presence of consolidations dots unilateral or bilateral with good cardiac function, HRCT chest result were recorded. Results: 197 patients are included in the study, with mean age 48 ±16.2 year , 52% male, 10% have DM, 9% have HTN, 5 % needed hospitalization, mean oxygen saturation were 95±5 percent, 152 patients confirmed COVID pneumonia with HRCT chest while 45 patients had normal HRCT chest , while chest ultrasonography positive finding for pneumonia in 128 patients while normal Chest ultrasonography 69patients ,Chest ultrasonography is having good association (R 0.690 p value <0.001)when correlated with HRCT to diagnose COVID 19 pneumonia. The sensitivity and specificity and accuracy of Chest ultrasonography in diagnosis of COVID19 pneumonia are 84.56% , 95.83% and 87.31% respectively when compared with HRCT chest.102 patients successfully followed within 15 days;all of them showing clinical and ultrasonographically improvement. Conclusion :Chest Ultrasonography is a promising cheap method for evaluation of COVID 19 pneumonia with high specificity , sensitivity and accuracy with less patients' exposure and virus spread when compared with HRCT chest .