Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study

Volpicelli, Giovanni; Gargani, Luna; Perlini, Stefano; Spinelli, Stefano; Barbieri, Greta; Lanotte, Antonella; Casasola, G. García de; Nogué-Bou, Ramon; Lamorte, Alessandro; Agricola, Eustachio; Villén, Tomás; Deol, Paramjeet; Nazerian, Peiman; Corradi, Francesco; Stefanone, Valerio Teodoro; Fraga, Denise Nicole; Navalesi, Paolo; Ferre, Robinson M.; Boero, Enrico; Martinelli, Giampaolo; Cristoni, Lorenzo; Perani, Cristiano; Vetrugno, Luigi; McDermott, Cian; Miralles-Aguiar, Francisco; Secco, Gianmarco; Zattera, Caterina; Salinaro, Francesco; Grignaschi, Alice; Boccatonda, Andrea; Giostra, Fabrizio; Infante, Marta Nogué; Covella, Michele; Ingallina, Giacomo; Burkert, Julia; Frumento, Paolo; Forfori, Francesco; Ghiadoni, Lorenzo; Fraccalini, Thomas; Vendrame, Alessandro; Basile, Vittoria; Cipriano, Alessandro; Frassi, Francesca; Santini, Massimo; Falcone, Marco; Menichetti, Francesco; Barcella, Bruno; Delorenzo, Marzia; Resta, F.; Vezzoni, Giulia; Bonzano, Marco; Briganti, Domenica Federica; Cappa, Giovanni; Zunino, Ilaria; Demitry, Lorenzo; Vignaroli, Damiano; Scattaglia, Lorenzo; Pietro, S. Di; Bazzini, Marco; Capozza, V; Gonzalez, Maria; Gibal, Rosa Vilella; Ibarz, Ramon Piñol; Alfaro, Luis Martin; Alfaro, Carlos Martin; Alins, Maria Galindo; Brown, A. Hedley; Dunlop, Hannah; Ralli, Maria; Persona, Paolo; Russel, Frances M.; Pang, Peter S.; Rovida, Serena; Deana, Cristian; Franchini, Diego

doi:10.1007/s00134-021-06373-7

Cited by 132 publications

(158 citation statements)

References 25 publications

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“…The capacity of LUS for early detection of COVID-19 pneumonia was already described in other publications [ 10 , 17 , 23 ]. Here, for the first time in primary care, we show the great relevance of LUS to predict the evolution of COVID-19 pneumonia diagnosed by ultrasound and confirmed by biological tests.…”

Section: Discussionmentioning

confidence: 78%

“…This study shows that primary care services can and should be in charge of the management and follow-up of approximately 70% of patients with COVID-19 pneumonia. Despite this, many patients with mild symptoms prefer to go to hospital emergency departments such as the mild phenotype group (n = 402) of Volpicelli et al [ 23 ]. These patients could be cared for by primary care services, decongesting hospital emergency services.…”

Section: Discussionmentioning

confidence: 99%

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The Risk of Hospitalization in COVID-19 Patients Can Be Predicted by Lung Ultrasound in Primary Care

Martínez-Redondo

Comas

Salud

et al. 2021

IJERPH

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Background: The usefulness of Lung Ultrasound (LUS) for the diagnosis of interstitial syndrome caused by COVID-19 has been broadly described. The aim of this study was to evaluate if LUS may predict the complications (hospital admission) of COVID-19 pneumonia in primary care patients. Methods: This observational study collects data from a cohort of 279 patients with clinical symptoms of COVID-19 pneumonia who attended the Balaguer Primary Health Care Area between 16 March 2020 and 30 September 2020. We collected the results of LUS scans reported by one general practitioner. We created a database and analysed the absolute and relative frequencies of LUS findings and their association with hospital admission. We found that different LUS patterns (diffuse, attenuated diffuse, and predominantly unilateral) were risk factors for hospital admission (p < 0.05). Additionally, an evolutionary pattern during the acute phase represented a risk factor (p = 0.0019). On the contrary, a normal ultrasound pattern was a protective factor (p = 0.0037). Finally, the presence of focal interstitial pattern was not associated with hospital admission (p = 0.4918). Conclusion: The lung ultrasound was useful to predict complications in COVID-19 pneumonia and to diagnose other lung diseases such as cancer, tuberculosis, pulmonary embolism, chronic interstitial pneumopathy, pleuropericarditis, pneumonia or heart failure.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

The Risk of Hospitalization in COVID-19 Patients Can Be Predicted by Lung Ultrasound in Primary Care

Martínez-Redondo

Comas

Salud

et al. 2021

IJERPH

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“…In addition, Volpicelli et al [ 19 ] reported an LUS sensitivity of 90.2% and specificity of 50.5% investigating early LUS under various inclusion criteria. Narinx et al [ 20 ] found an LUS sensitivity of 93.3% and specificity of 21.3% for patients at ED admission.…”

Section: Discussionmentioning

confidence: 99%

Significance of Lung Ultrasound in Patients with Suspected COVID-19 Infection at Hospital Admission

et al. 2021

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With a lung ultrasound (LUS) the typical findings are interstitial pneumonia. COVID-19 pneumonia is often manifested in sub-pleural areas, which is preferably detected by sonography. An RT-PCR test cannot always ensure a safe differentiation of COVID-19- and non-diseased cases. Clinically challenging is that a reliable and time efficient decision regarding COVID-19 suspects requiring isolation. Therefore, this study was aimed at evaluating the significance of LUS in symptomatic patients with COVID-19 suspicion at hospital admission. A total of 101 patients admitted to a suspect ward with COVID-19-typical symptoms were assessed. All patients received prospectively a standardized LUS at admission. Patients were classified as LUS-positive and -negative cases based on a specific LUS score. The RT-PCR test in combination with the clinical findings served as a reference. Correctly classified were 14/15 COVID-19 diseased suspects as LUS-positive (sensitivity: 93.3%). Twenty-seven out of 61 non-positive cases were classified as false positive with LUS (specificity: 55.7%). In 34/35 patients who were assessed as LUS negative, no COVID-19 disease was detected during the hospitalization. The PPV and NPV of the LUS were 34.1% and 97.1%. LUS is a valuable tool in symptomatic patients for the assessment of COVID-19-disease. The high negative predictive value of LUS is helpful to rule out the disease.

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“…During the COVID-19 pandemic, LUS has been a useful technique for the early diagnosis of COVID-19 pneumonia [41,42]. Typical findings of LUS consist in an interstitial syndrome, from focal pleural line irregularities to diffuse and confluent B lines, as well as an alveolar syndrome, from small subpleural hypoechoic images to large alveolar consolidations with air bronchograms [43] (Figure 3).…”

Section: Using Lus To Diagnose Covid-19 Pneumoniamentioning

confidence: 99%

Low Dose Chest CT and Lung Ultrasound for the Diagnosis and Management of COVID-19

Finance

Zieleskewicz

Habert

et al. 2021

JCM

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Background: The COVID-19 pandemic has provided an opportunity to use low- and non-radiating chest imaging techniques on a large scale in the context of an infectious disease, which has never been done before. Previously, low-dose techniques were rarely used for infectious diseases, despite the recognised danger of ionising radiation. Method: To evaluate the role of low-dose computed tomography (LDCT) and lung ultrasound (LUS) in managing COVID-19 pneumonia, we performed a review of the literature including our cases. Results: Chest LDCT is now performed routinely when diagnosing and assessing the severity of COVID-19, allowing patients to be rapidly triaged. The extent of lung involvement assessed by LDCT is accurate in terms of predicting poor clinical outcomes in COVID-19-infected patients. Infectious disease specialists are less familiar with LUS, but this technique is also of great interest for a rapid diagnosis of patients with COVID-19 and is effective at assessing patient prognosis. Conclusions: COVID-19 is currently accelerating the transition to low-dose and “no-dose” imaging techniques to explore infectious pneumonia and their long-term consequences.

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Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study

Cited by 132 publications

References 25 publications

The Risk of Hospitalization in COVID-19 Patients Can Be Predicted by Lung Ultrasound in Primary Care

The Risk of Hospitalization in COVID-19 Patients Can Be Predicted by Lung Ultrasound in Primary Care

Significance of Lung Ultrasound in Patients with Suspected COVID-19 Infection at Hospital Admission

Low Dose Chest CT and Lung Ultrasound for the Diagnosis and Management of COVID-19

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