Abstract
Background and Objectives: The potential role of lung ultrasound (LUS) in characterizing lung involvement in Coronavirus disease 2019 (COVID-19) is still debated. The aim of the study was to estimate sensitivity of admission LUS for the detection of SARS-CoV-2 lung involvement using Chest-CT (Computed Tomography) as reference standard in order to assess LUS usefulness in ruling out COVID-19 pneumonia in the Emergency Department (ED). Methods: Eighty-two patients with confirmed COVID-19 and signs of lung involvement on Chest-CT were consecutively admitted to our hospital and recruited in the study. Chest-CT and LUS examination were concurrently performed within the first 6–12h from admission. Sensitivity of LUS was calculated using CT findings as a reference standard. Results: Global LUS sensitivity in detecting COVID-19 pulmonary lesions was 52%. LUS sensitivity ranged from 8% in case of focal and sporadic ground-glass opacities (mild disease), to 52% for a crazy-paving pattern (moderate disease) and up to 100% in case of extensive subpleural consolidations (severe disease), although LUS was not always able to detect all the consolidations assessed at Chest-CT. LUS sensitivity was higher in detecting a typical Chest-CT pattern (60%) and abnormalities showing a middle-lower zone predominance (79%). Conclusions: As admission LUS may result falsely negative in most cases, it should not be considered as a reliable imaging tool in ruling out COVID-19 pneumonia in patients presenting in ED. It may at least represent an expanded clinical evaluation that needs integration with other diagnostic tests (e.g., nasopharyngeal swab, Chest-CT).
Highlights
Since the initial cluster of pneumonia cases in Wuhan in December 2019 [1], the so-called SARS-CoV-2 has spread globally, and the World Health Organization (WHO)declared the novel coronavirus disease (COVID-19) pandemic on 11 March 2020 [2]. COVID-19 may virtually show a systemic involvement, the lung is the most common target organ
We present a comparative diagnostic analysis between lung ultrasound (LUS) and Computed Tomography (CT) findings in the first series of 82 consecutive patients with COVID-19 pneumonia admitted to our Research Institute “Fondazione Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy, between 19 March and 13 April 2020
The present study shows that the detection rate for COVID-19 lung findings by LUS
Summary
Since the initial cluster of pneumonia cases in Wuhan in December 2019 [1], the so-called SARS-CoV-2 has spread globally, and the World Health Organization (WHO)declared the novel coronavirus disease (COVID-19) pandemic on 11 March 2020 [2]. COVID-19 may virtually show a systemic involvement, the lung is the most common target organ. COVID-19 is associated with a significant burden of morbidity and mortality In this context, chest imaging plays a key role in the triage and management of patients with confirmed or suspected SARS-CoV-2 infection. The reported sensitivity of chest X-Rays for COVID-19 pneumonia is relatively low, in the early phase of the disease [3]. The aim of the study was to estimate sensitivity of admission LUS for the detection of SARS-CoV-2 lung involvement using. Chest-CT (Computed Tomography) as reference standard in order to assess LUS usefulness in ruling out COVID-19 pneumonia in the Emergency Department (ED). Methods: Eighty-two patients with confirmed COVID-19 and signs of lung involvement on Chest-CT were consecutively admitted to our hospital and recruited in the study. Results: Global LUS sensitivity in detecting COVID-19 pulmonary lesions was
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