Abstract
COVID-19 pneumonia can be severe, with an unpredictable evolution and high mortality prevalence in older patients. The diagnosis is usually performed by RT-PCR or CT chest scan. Lung ultrasonography (LUS) has been proposed as an alternative method to monitor patients with COVID-19 pneumonia.To assess the diagnostic performance of LUS, we performed LUS using a portable device and adapting a protocol already used in Acute Respiratory Syndrome. We used the score obtained with the index we created to assess for LUS diagnostic performance as compared to lung CT chest scan and to predict for oxygen requirements.Daily bedside LUS was easy to perform and microbiologically safe. LUS was 89% sensitive and 100% specific in predicting CT chest scan abnormalities, and 95% sensitive and 67% specific in detecting oxygen requirements.This is the first report on the diagnostic performance of LUS as compared to CT chest scan for the diagnosis of COVID-19 pneumonia and assessments of oxygen requirements by LUS. LUS could help in the orientation of dyspneic patients to intensive care. It could also be proposed when there is limited access to CT scan in the context of a pandemic crisis, or to implement clinical lung examinations for outpatient follow-up.
Highlights
COVID-19 pneumonia can be severe and its evolution unpredictable [1, 2] with a high mortality prevalence of 26% in older inpatients [3]
Characteristics of patients and diagnostic performances of lung ultrasonography (LUS) in detecting lung damage observed on Computed Tomography www.aging-us.com (CT) chest scan in COVID-19
They had damage detected on CT scan described as minor (10%), moderate (38%), extensive (46%) or severe (6%). 72% of all patients had a positive RT-PCR for SARS-Cov-2. 80% had at least one significant comorbidity, 30% had two comorbidities, and
Summary
COVID-19 pneumonia can be severe and its evolution unpredictable [1, 2] with a high mortality prevalence of 26% in older inpatients [3]. Computed Tomography www.aging-us.com (CT) chest scan is the imaging "gold standard" to detect COVID-19 pneumonia, in particular when RTPCR is negative [4, 5]. In the dramatic context of a pandemic situation, access to CT chest scan can be limited, and repeated CT scans, if an imaging follow-up is required, can be difficult to perform due to costs, invasiveness and infectious risks. To date no study has yet assessed the diagnostic performance of LUS in COVID-19 as compared to CT chest scan. This information is of major importance in the event of a second wave, to manage patient flows, or in emerging infectious lung diseases
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