Diagnostic accuracy of chest ultrasound in patients with pneumonia in the intensive care unit: A single‐hospital study

Bitar, Zouheir Ibrahim; Maadarani, Ossama; El-Shably, AlAsmar Mohammed; Al-Ajmi, Mubarak Juwaied

doi:10.1002/hsr2.102

Cited by 23 publications

(17 citation statements)

References 23 publications

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“…In addition, it was found that the location of the lesions in each patient with LUS-positive was exactly consistent with that on CT after comparison. The inflammation lesions of two patients were fortunately distributed near the pleura, so ultrasound can determine the location and size [14,23]. As for blood-test results, one of nine patients (11.11%) showed elevated ALT and AST (164U/ L, 94U/L, normal value <40U/L).…”

Section: Discussionmentioning

confidence: 97%

Application Value of Lung Ultrasound in Asymptomatic Patients with Confirmed COVID-19

Lin¹,

Zhang²,

Kou³

et al. 2020

Advanced Ultrasound in Diagnosis and Therapy

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To investigate the value of lung ultrasound (LUS) in asymptomatic patients with confirmed COVID-19. Methods:A retrospective analysis was performed on nine patients in a designated isolation hospital in Sanya from February 22nd, 2020 to February 23rd, 2020. All patients were confirmed with COVID-19 pneumonia by PCR test, but none had the typical symptoms of COVID-19. All patients first underwent LUS examination and then chest computed tomography (CT) scanning. The application value of LUS in asymptomatic confirmed patients with COVID-19 was evaluated, compared with chest CT which was regarded as the golden standard.Results: Among nine asymptomatic patients with COVID-19, there were two cases (22.22%) with abnormal ultrasonic manifestations, of which one (11.11%) showed a fusion B3-line in zone 5 of the right lung, and the other showed localized pulmonary consolidation in zone 6 of the left lung. The remaining seven cases (77.78%) showed no abnormal changes in LUS, but only clear pleura sliding sign and A-line. Chest CT showed abnormal changes in three cases (33.33%). Two of them (22.22%) showed flocculent high-density shadow at the base of both lungs (especially in the right lung), while the other case showed ground-glass opacity with thickened interlobular septal in the left lower lobe, involving the pleura. There were no abnormalities on chest CT of the remaining six cases (66.67%). The two (22.22%) LUS-positive patients were in complete coincidence with CT-positive patients. This study showed that the coincidence rate of the two examination methods was 88.89%. Taking chest CT as golden standard, the sensitivity, specificity, positive predictive value, negative predictive value, and Kappa value of lung ultrasound in the diagnosis of COVID-19 were 66.67%, 100%, 100%, 85.71%, and 0.727, respectively. Conclusion:LUS can evaluate lung lesions in asymptomatic patients with COVID-19. Compared with chest CT, the diagnostic coincidence rate and diagnostic consistency of LUS are relatively higher. For this asymptomatic type of patient, ultrasound can be used as a diagnosis method, which can avoid the risk of radiation exposure in a short period of time. As a rapid and dynamic assessment method, LUS can cooperate with remote consultation to provide timely and accurate guidance for clinical diagnosis and treatment when necessary.

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Section: Discussionmentioning

confidence: 97%

Application Value of Lung Ultrasound in Asymptomatic Patients with Confirmed COVID-19

Lin¹,

Zhang²,

Kou³

et al. 2020

Advanced Ultrasound in Diagnosis and Therapy

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show abstract

“…For example, it is quick, affordable, requires no ionizing radiation, can be done at the bedside, and it addresses many of the same clinical questions that chest radiography and CT scans address[ 123 ]. In fact, lung ultrasound has been shown to be more sensitive than traditional chest radiography in the detection of infections involving the lower respiratory tract[ 124 , 125 ]. POCUS can not only be useful in the initial diagnosis of COVID-19, but it is also useful in following disease progression and monitoring for many of the associated complications[ 34 ].…”

Section: Evolving Trends and Future Directionsmentioning

confidence: 99%

COVID-19 imaging: Diagnostic approaches, challenges, and evolving advances

Pezzutti

Wadhwa

Makary

2021

WJR

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The role of radiology and the radiologist have evolved throughout the coronavirus disease-2019 (COVID-19) pandemic. Early on, chest computed tomography was used for screening and diagnosis of COVID-19; however, it is now indicated for high-risk patients, those with severe disease, or in areas where polymerase chain reaction testing is sparsely available. Chest radiography is now utilized mainly for monitoring disease progression in hospitalized patients showing signs of worsening clinical status. Additionally, many challenges at the operational level have been overcome within the field of radiology throughout the COVID-19 pandemic. The use of teleradiology and virtual care clinics greatly enhanced our ability to socially distance and both are likely to remain important mediums for diagnostic imaging delivery and patient care. Opportunities to better utilize of imaging for detection of extrapulmonary manifestations and complications of COVID-19 disease will continue to arise as a more detailed understanding of the pathophysiology of the virus continues to be uncovered and identification of predisposing risk factors for complication development continue to be better understood. Furthermore, unidentified advancements in areas such as standardized imaging reporting, point-of-care ultrasound, and artificial intelligence offer exciting discovery pathways that will inevitably lead to improved care for patients with COVID-19.

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“…11,12 In the ICU setting, LUS was superior to chest X-ray in detecting pneumonia. 13 Although CXR has poor sensitivity and specificity compared to chest CT and LUS, it remains the standard protocol for diagnosing the disease. Plain radiographs can miss up to 40% of confirmed COVID-19 cases due to the nature of the disease, in which lesions are peripherally distributed, and pathology is evident primarily in the terminal alveoli and close to the pleural interface.…”

Section: Resultsmentioning

confidence: 99%

Appropriateness of lung ultrasound for the diagnosis of COVID‐19 pneumonia

Bitar

Shamsah

Maadarani

et al. 2021

Health Science Reports

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Background Chest radiography (CXR) and computerized tomography (CT) are the standard methods for lung imaging in diagnosing COVID‐19 pneumonia in the intensive care unit (ICU), despite their limitations. This study aimed to assess the performance of bedside lung ultrasound examination by a critical care physician for the diagnosis of COVID‐19 pneumonia during acute admission to the ICU. Method This was an observational, prospective, single‐center study conducted in the intensive care unit of Adan General Hospital from April 10, 2020, to May 26, 2020. The study included adults with suspicion of COVID‐19 Infection who were transferred to the ICU. Patients were admitted to the ICU directly from the ED after reverse transcriptase‐polymerase chain reaction (RT‐PCR) swabs were sent to the central virology laboratory in Kuwait, and the results were released 16 to 24 hours after the time of admission. A certified intensivist in critical care ultrasound performed the lung ultrasound within 12 hours of the patient's admission to the ICU. The treating physician confirmed the diagnosis of COVID‐19 pneumonia based on a set of clinical features, inflammatory markers, biochemical profile studies, RT‐PCR test results, and CXR. Results Of 77 patients with suspected COVID‐19 pneumonia, 65 (84.4%) were confirmed. The median age of the patients was 48 (31‐68) years, and 51 (71%) were men. In the group of patients with confirmed COVID‐19 pneumonia, LUS revealed four signs suggestive of COVID‐19 pneumonia in 63 patients (96.9%) (sensitivity 96.9%, CI 85%‐99.5%). Two patients presented with unilateral lobar pneumonia without other ultrasonic signs of COVID‐19 pneumonia but with positive RT‐PCR results. Among patients in the group without COVID‐19 pneumonia who had negative RT‐PCR results, 11 (91.7%) were LUS negative for COVID‐19 pneumonia (specificity 91.7%, 95% CI 58.72%‐99.77%). Conclusions During the COVID‐19 outbreak, LUS allows the identification of early signs of interstitial pneumonia. LUS patterns that show a combination of the four major signs offer high sensitivity and specificity compared to nasopharyngeal RT‐PCR.

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Diagnostic accuracy of chest ultrasound in patients with pneumonia in the intensive care unit: A single‐hospital study

Cited by 23 publications

References 23 publications

Application Value of Lung Ultrasound in Asymptomatic Patients with Confirmed COVID-19

Application Value of Lung Ultrasound in Asymptomatic Patients with Confirmed COVID-19

COVID-19 imaging: Diagnostic approaches, challenges, and evolving advances

Appropriateness of lung ultrasound for the diagnosis of COVID‐19 pneumonia

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