tetano
Editor, Senior Moderator
J Ultrasound Med
. 2021 Sep 4.
doi: 10.1002/jum.15822. Online ahead of print.
The Value of Lung Ultrasound to Detect the Early Pleural and Pulmonary Pathologies in Nonhospitalized COVID-19-Suspected Cases in a Population with a Low Prevalence of COVID-19 Infection: A Prospective Study in 297 Subjects
Ehsan Safai Zadeh[SUP] 1 [/SUP], Katharina P Huber[SUP] 1 [/SUP], Christoph F Dietrich[SUP] 2 [/SUP], Corinna Trenker[SUP] 3 [/SUP], Evelyn Martin[SUP] 4 [/SUP], Björn Beutel[SUP] 5 [/SUP], Birgit Wollenberg[SUP] 6 [/SUP], Christian Görg[SUP] 1 7 [/SUP]
Affiliations
Abstract
Objectives: This prospective study aimed to evaluate the value of B-mode lung ultrasound (LUS) for the early diagnosis of coronavirus disease 2019 (COVID-19) infection in nonhospitalized COVID-19 suspected cases in a population with a low prevalence of disease.
Methods: From April 2020 to June 2020, in an ambulatory testing center for COVID-19-suspected cases, 297 subjects were examined by LUS before a nasopharyngeal swab was taken for a reverse transcription polymerase chain reaction (RT-PCR) test. The following LUS findings were defined as pathological ultrasound findings and were analyzed: the presence of 1) pleural effusion, 2) B-lines, 3) fragmented visceral pleura, 4) consolidation, and 5) air bronchogram in the consolidation. The LUS findings were compared with the RT-PCR test results.
Results: The result of the RT-PCR test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was positive in 11 and negative in 286 subjects, and the prevalence of COVID-19 infection in the study participants was 3.7%. On LUS, a pathological finding could be detected in 56/297 (18.9%) study participants. The LUS revealed a sensitivity of 27.3%, a specificity of 81.5%, a positive predictive value of 5.4%, a negative predictive value of 96.7%, and a diagnostic accuracy of 79.9% for the identification of COVID-19 infection.
Conclusions: For the identification of COVID-19 infection, LUS is highly sensitive to the patient spectrum and to the prevalence of the disease. Due to the low diagnostic performance in nonhospitalized COVID-19 cases in low-prevalence areas, LUS cannot be considered to be an adequate method for making a diagnosis in this group.
Keywords: COVID-19-suspected cases; SARS-CoV-2; low prevalence; lung ultrasound; nonhospitalized; pleural and pulmonary pathologies.
. 2021 Sep 4.
doi: 10.1002/jum.15822. Online ahead of print.
The Value of Lung Ultrasound to Detect the Early Pleural and Pulmonary Pathologies in Nonhospitalized COVID-19-Suspected Cases in a Population with a Low Prevalence of COVID-19 Infection: A Prospective Study in 297 Subjects
Ehsan Safai Zadeh[SUP] 1 [/SUP], Katharina P Huber[SUP] 1 [/SUP], Christoph F Dietrich[SUP] 2 [/SUP], Corinna Trenker[SUP] 3 [/SUP], Evelyn Martin[SUP] 4 [/SUP], Björn Beutel[SUP] 5 [/SUP], Birgit Wollenberg[SUP] 6 [/SUP], Christian Görg[SUP] 1 7 [/SUP]
Affiliations
- PMID: 34480772
- DOI: 10.1002/jum.15822
Abstract
Objectives: This prospective study aimed to evaluate the value of B-mode lung ultrasound (LUS) for the early diagnosis of coronavirus disease 2019 (COVID-19) infection in nonhospitalized COVID-19 suspected cases in a population with a low prevalence of disease.
Methods: From April 2020 to June 2020, in an ambulatory testing center for COVID-19-suspected cases, 297 subjects were examined by LUS before a nasopharyngeal swab was taken for a reverse transcription polymerase chain reaction (RT-PCR) test. The following LUS findings were defined as pathological ultrasound findings and were analyzed: the presence of 1) pleural effusion, 2) B-lines, 3) fragmented visceral pleura, 4) consolidation, and 5) air bronchogram in the consolidation. The LUS findings were compared with the RT-PCR test results.
Results: The result of the RT-PCR test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was positive in 11 and negative in 286 subjects, and the prevalence of COVID-19 infection in the study participants was 3.7%. On LUS, a pathological finding could be detected in 56/297 (18.9%) study participants. The LUS revealed a sensitivity of 27.3%, a specificity of 81.5%, a positive predictive value of 5.4%, a negative predictive value of 96.7%, and a diagnostic accuracy of 79.9% for the identification of COVID-19 infection.
Conclusions: For the identification of COVID-19 infection, LUS is highly sensitive to the patient spectrum and to the prevalence of the disease. Due to the low diagnostic performance in nonhospitalized COVID-19 cases in low-prevalence areas, LUS cannot be considered to be an adequate method for making a diagnosis in this group.
Keywords: COVID-19-suspected cases; SARS-CoV-2; low prevalence; lung ultrasound; nonhospitalized; pleural and pulmonary pathologies.