Early Lung Ultrasound Findings in Patients With COVID‐19 Pneumonia: A Retrospective Multicenter Study of 479 Patients

Objectives Lung ultrasound (LUS) holds the promise of an accurate, radiation‐free, and affordable diagnostic and monitoring tool in coronavirus disease 2019 (COVID‐19) pneumonia. We sought to evaluate the usefulness of LUS in the diagnosis of patients with respiratory distress and suspicion of inter...

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Published in:	Journal of ultrasound in medicine Vol. 41; no. 10; pp. 2547 - 2556
Main Authors:	Caroselli, Costantino, Blaivas, Michael, Marcosignori, Matteo, Tung Chen, Yale, Falzetti, Sara, Mariz, José, Fiorentino, Romano, Pinto Silva, Rafael, Gomes Cochicho, Joana, Sebastiani, Simone, Carlini, Mauro, Polati, Enrico, Simonini, Valentina, Malagola, Sara, Raffaldi, Irene, Longo, Daniele
Format:	Journal Article
Language:	English
Published:	Hoboken, USA John Wiley & Sons, Inc 01-10-2022
Subjects:	COVID‐19 lung ultrasound Original point‐of‐care SARS‐CoV‐2 COVID-19 SARS-CoV-2 point-of-care lung ultrasound
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Summary:	Objectives Lung ultrasound (LUS) holds the promise of an accurate, radiation‐free, and affordable diagnostic and monitoring tool in coronavirus disease 2019 (COVID‐19) pneumonia. We sought to evaluate the usefulness of LUS in the diagnosis of patients with respiratory distress and suspicion of interstitial severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pneumonia, in comparison to other imaging modalities. Methods This was a multicenter, retrospective study. LUS was performed, on Emergency Department (ED) arrival of patients presenting for possible COVID‐19 evaluation, by trained emergency physicians, before undergoing conventional radiologic examination or while waiting for the report. Scans were performed using longitudinal transducer orientation of the lung regions. CXR was interpreted by radiologists staffing ED radiology. Subjects were divided into two group based on molecular test results. LUS findings were compared to COVID test results, nonlaboratory data, and other imaging for each patient. Categorical variables were expressed as percentages and continuous variables as median ± standard error. Results A total of 479 patients were enrolled, 87% diagnosed with SARS‐CoV‐2 by molecular testing. COVID positive and COVID negative patients differed with respect to sex, presence of fever, and white blood cells count. Most common findings on lung point of care ultrasound (POCUS) for COVID‐positive patients were B‐lines, irregular pleural lines, and small consolidation. Normal chest X‐ray was found in 17.89% of cases. Conclusions This 479 patient cohort, with COVID‐19, found LUS to be noninferior to chest X‐ray (CXR) for diagnostic accuracy. In this study, COVID‐positive patients are most likely to show B lines and sub‐pleural consolidations on LUS examination.
Bibliography:	The authors have no conflicts of interest relevant to this article. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0278-4297 1550-9613
DOI:	10.1002/jum.15944