Abstract
BackgroundThe use of lung ultrasound (LU) with COVID-19 pneumonia patients should be validated in the field of primary care (PC). Our study aims to evaluate the correlation between LU and radiographic imaging in PC patients with suspected COVID-19 pneumonia.MethodsThis observational, prospective and multicentre study was carried out with patients from a PC health area whose tests for COVID-19 and suspected pneumonia had been positive and who then underwent LU and a digital tomosynthesis (DT). Four PC physicians obtained data regarding the patients’ symptoms, examination, medical history and ultrasound data for 12 lung fields: the total amount of B lines (zero to four per field), the irregularity of the pleural line, subpleural consolidation, lung consolidation and pleural effusion. These data were subsequently correlated with the presence of pneumonia by means of DT, the need for hospital admission and a consultation in the hospital emergency department in the following 15 days.ResultsThe study was carried out between November 2020 and January 2021 with 70 patients (40 of whom had pneumonia, confirmed by means of DT). Those with pneumonia were older, had a higher proportion of arterial hypertension and lower oxygen saturation (sO2). The number of B lines was higher in patients with pneumonia (16.53 vs. 4.3, p < 0.001). The area under the curve for LU was 0.87 (95% CI 0.78–0.96, p < 0.001), and when establishing a cut-off point of six B lines or more, the sensitivity was 0.875 (95% CI 0.77–0.98, p < 0.05), the specificity was 0.833 (95% CI 0.692–0.975, p < 0.05), the positive-likelihood ratio was 5.25 (95% CI 2.34–11.79, p < 0.05) and the negative-likelihood ratio was 0.15 (95% CI 0.07–0.34, p < 0.05). An age of ≥ 55 and a higher number of B lines were associated with admission. Patients who required admission (n = 7) met at least one of the following criteria: ≥ 55 years of age, sO2 ≤ 95%, presence of at least one subpleural consolidation or ≥ 21 B lines.ConclusionsLU has great sensitivity and specificity for the diagnosis of COVID-19 pneumonia in PC. Clinical ultrasound findings, along with age and saturation, could, therefore, improve decision-making in this field.
Highlights
During the recent SARS-CoV-2 pandemic, lung ultrasound (LU) has been a useful tool in the diagnosis and Fabuel Ortega et al The Ultrasound Journal (2022) 14:11 management of COVID-19 pneumonia [1].The low sensitivity of chest radiography has led to the proposal that computed tomography (CT) could be used as the gold standard [2]
Epidemiological context Our study period, which ranged between the 25th of November 2020 and the 29th of January 2021, included the highest 14-day cumulative number of cases per 100,000 inhabitants, in Ultrasound correlation and COVID‐19 pneumonia The mean sum of the B lines of all the fields of those patients who were diagnosed as having pneumonia by means of Digital tomosynthesis (DT) (16.53, 95% Confidence interval (CI) 13.23–19.81) was significantly higher than those who did not have pneumonia (4.3, 95% CI 2.04–6), with p < 0.001
The area under the curve (AUC) was 0.87, and when establishing a cut-off point of six B lines or more, the S was 0.875, the Sp was 0.833, the positive predictive value (PPV) was 0.875 and the Negative predictive value (NPV) was 0.833 for the diagnosis of COVID pneumonia (Table 4 and Fig. 6)
Summary
During the recent SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic, lung ultrasound (LU) has been a useful tool in the diagnosis and Fabuel Ortega et al The Ultrasound Journal (2022) 14:11 management of COVID-19 pneumonia (coronavirus disease 2019) [1].The low sensitivity of chest radiography has led to the proposal that computed tomography (CT) could be used as the gold standard [2]. DT is considered to be an emerging application that has some of the tomographic benefits of CT, since it provides multiple anatomic images, but has a lower cost and radiation dose [12]. It is normally used as a diagnostic tool for breast cancer, but has been shown to be useful in lung pathologies, and better than simple chest radiography in the case of pulmonary nodules or cystic fibrosis, as it reduces superposition artefacts and improves resolution [13, 14]. Our study aims to evaluate the correlation between LU and radiographic imaging in PC patients with suspected COVID-19 pneumonia
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
