A simple lung ultrasound protocol for the screening of COVID-19 pneumonia in the emergency department

Dacrema, Alessandro; Silva, Matteo; Rovero, Luca; Vertemati, Valeria; Losi, Giulia; Piepoli, Massimo F; Sacchi, Roberto; Nazerian, Peiman; Pagani, Laura; Tinelli, Valentina; Poggiali, Erika; Bastoni, Davide; Vercelli, Andrea; Magnacavallo, Andrea

doi:10.1007/s11739-020-02596-6

Cited by 11 publications

(10 citation statements)

References 23 publications

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“…We planned a deep structural and environmental re-organization of the ED, 3,4 and designed a survival strategy based on a clear triage process starting from the strictly collaboration between the triage nurse, who interviewed the patient, and the emergency clinician, who performed the point-of-care Lung Ultrasound (LUS) in a "key area" of the triage room, in order to quickly identify ultrasound signs of pulmonary interstitial syndrome. In our experience, we confirmed the role of LUS as a safe, easy and sensitive imaging technique to assess the lung and pleural involvement in COVID-19 pneumonia, 5,6 as reported in literature. [7][8][9][10][11] In our experience, during the "phase 1" of the Italian COVID-19 epidemic, LUS has been a powerful method to early detect lung damage even in patients who did not complain of respiratory symptoms and/or fever.…”

Section: Introductionsupporting

confidence: 88%

COVID-19 or not COVID-19, that is the question. The role of screening criteria and point-of-care lung ultrasound in the triage decision-making process in an Emergency Department during the phase 2 of the COVID-19 Italian epidemic

et al. 2021

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In the COVID-19 era the real challenge for the Emergency Departments (ED) is to avoid the spread of the viral infection within the so called “clean area” of the emergency room and the hospital. Different protocols have been proposed and adopted in the EDs to quickly identify suspected COVID-19 patients and to correctly manage these patients, all based on clinical and epidemiological criteria. To the best of our knowledge, our pre-triage decisional making-process first integrates the pre-triage interview with pointof- care Lung Ultrasound (LUS) performed in the triage area. The aim of our study is to assess the sensitivity and specificity of our screening clinical and/or epidemiological criteria, and to investigate the role of LUS in the triage decision-making process during the “phase 2” of the COVID-19 Italian epidemic. Our study confirms the pivotal role of the triage in the decision-making process and the management of the entire ED, and it demonstrates that further studies are necessary to validate the role of LUS as tool to promptly identify COVID-19 patients, if combined with a correct pre-triage interview.

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Section: Introductionsupporting

confidence: 88%

COVID-19 or not COVID-19, that is the question. The role of screening criteria and point-of-care lung ultrasound in the triage decision-making process in an Emergency Department during the phase 2 of the COVID-19 Italian epidemic

et al. 2021

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“…Dacrema et al [ 18 ] used a rapid and simplified scanning method referred to as LUSCOP, which includes six regions (apex, middle, and basal), to evaluate 130 patients. They reported an achievement rate of 99.2% in identifying COVID-19 pneumonia [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of two different lung ultrasound imaging protocols in COVID-19 pneumonia

Ökmen¹,

Yıldız

Soyaslan

et al. 2022

Ultrasonography

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The purpose of our study it was aimed to determine the effectiveness of two different Lung ultrasonography (LUS) methods that can be used in the diagnosis of COVID-19 and to investigate its correlation with computed tomography (CT). Methods:In this prospective ,randomized and single blind study 60 patients with COVID-19 were included the study.Patients were randomized to either Group 12 zone LUS (n:30) or Group 14 zone LUS (n:30) .The evaluation parameters were to determine the correlation between LUS and Thorax-CT scores. The secondary outcome measure examined the characteristic features of the findings in Thorax-CT and LUS. Results:The study was completed with a total of 59 patients .A moderate and high degree correlation was found between the CT and LUS scores calculated according to the total score in the 12-zone and 14-zone study groups. There was no statistically significant difference between the groups in terms of lesion types detected in patients on LUS and CT (p<0.05).Left lung lower lobe CT scores in the 14-zone study group were statistically significantly lower than the 12-zone group (p= 0.019).Left lower lobe CT LUS score correlation was highly correlated in 14 regions examined group (p <0.001/r: 0.954). Conclusions:The results of our study indicated that the two different LUS examination methods performed on the different patients had similar findings in terms of diagnosis and their correlation with the results of the CT.

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“…Our study identified nine studies comparing LUS with CT for the diagnosis of interstitial pneumonia caused by COVID-19 [8][9][10][11][12][13][14][15][16]. In four out of five cases the diagnoses done by LUS and CT were in agreement.…”

Section: Principal Findingsmentioning

confidence: 85%

“…A total of 1896 documents were retrieved. After reading the titles, abstracts, and full text of the documents, nine articles were included in the analysis [8][9][10][11][12][13][14][15][16] (Figure 1).…”

Section: Literature Selection Processmentioning

confidence: 99%

A Comparison of Lung Ultrasound and Computed Tomography in the Diagnosis of Patients with COVID-19: A Systematic Review and Meta-Analysis

et al. 2021

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Background Lung ultrasound (LUS) and computed tomography (CT) can both be used for diagnosis of interstitial pneumonia caused by coronavirus disease 2019 (COVID-19), but the agreement between LUS and CT is unknown. Purpose to compare the agreement of LUS and CT in the diagnosis of interstitial pneumonia caused by COVID-19. Materials and Methods We searched PubMed, Cochrane library, Embase, Chinese Biomedicine Literature, and WHO COVID-19 databases to identify studies that compared LUS with CT in the diagnosis of interstitial pneumonia caused by COVID-19. We calculated the pooled overall, positive and negative percent agreements, diagnostic odds ratio (DOR) and the area under the standard receiver operating curve (SROC) for LUS in the diagnosis of COVID-19 compared with CT. Results We identified 1896 records, of which nine studies involving 531 patients were finally included. The pooled overall, positive and negative percentage agreements of LUS for the diagnosis of interstitial pneumonia caused by COVID-19 compared with CT were 81% (95% confidence interval [CI] 43–99%), 96% (95% CI, 80–99%, I2 = 92.15%) and 80% (95%CI, 60–92%, I2 = 92.85%), respectively. DOR was 37.41 (95% CI, 9.43–148.49, I2 = 63.9%), and the area under the SROC curve was 0.94 (95% CI, 0.92–0.96). The quality of evidence for both specificity and sensitivity was low because of heterogeneity and risk of bias. Conclusion The level of diagnostic agreement between LUS and CT in the diagnosis of interstitial pneumonia caused by COVID-19 is high. LUS can be therefore considered as an equally accurate alternative for CT in situations where molecular tests are not available.

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A simple lung ultrasound protocol for the screening of COVID-19 pneumonia in the emergency department

Cited by 11 publications

References 23 publications

COVID-19 or not COVID-19, that is the question. The role of screening criteria and point-of-care lung ultrasound in the triage decision-making process in an Emergency Department during the phase 2 of the COVID-19 Italian epidemic

COVID-19 or not COVID-19, that is the question. The role of screening criteria and point-of-care lung ultrasound in the triage decision-making process in an Emergency Department during the phase 2 of the COVID-19 Italian epidemic

Comparison of two different lung ultrasound imaging protocols in COVID-19 pneumonia

A Comparison of Lung Ultrasound and Computed Tomography in the Diagnosis of Patients with COVID-19: A Systematic Review and Meta-Analysis

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