The association of lung ultrasound images with COVID‐19 infection in an emergency room cohort

Abstract

Summary Lung ultrasound could facilitate the triage of patients with suspected COVID‐19 infection admitted to the emergency room. We developed a predictive model for COVID‐19 diagnosis based on lung ultrasound and clinical features. We used ultrasound to image the lung bilaterally at two anterior sites, one and two hands below each clavicle, and a posterolateral site that was the posterior transverse continuation from the lower anterior site. We studied 100 patients, 31 of whom had a COVID‐19 positive reverse transcriptase polymerase chain reaction. A positive test was independently associated with: quick sequential organ failure assessment score ≥1; ≥3 B‐lines at the upper site; consolidation and thickened pleura at the lower site; and thickened pleura line at the posterolateral site. The model discrimination was an area (95%CI) under the receiver operating characteristic curve of 0.82 (0.75–0.90). The characteristics (95%CI) of the model’s diagnostic threshold, applied to the population from which it was derived, were: sensitivity, 97% (83–100%); specificity, 62% (50–74%); positive predictive value, 54% (41–98%); and negative predictive value, 98% (88–99%). This model may facilitate triage of patients with suspected COVID‐19 infection admitted to the emergency room.

The utility of lung ultrasound in COVID-19: A systematic scoping review

“…14 LUS specificity may therefore be underestimated in studies where LUS is compared only to RT-PCR. For example, in the work by Bar et al 37 specificity was 62% (vs. RT-PCR) but in Tung-Chen et al 31 specificity was 79% (vs. CT).…”

“…Bar et al 37 studied 100 adults presenting to an ED with suspected COVID-19. There were 31 patients who tested RT-PCR positive but CT results were not recorded.…”

Lung Sonography in Obstetrics during COVID-19

“…Lediglich ausgeprägte breitbasige Konsolidierungen mit reduzierter Perfusion sind bislang noch nicht bei anderen Lungenerkrankungen beschrieben worden und daher nach derzeitigem Kenntnisstand als typisch für COVID-19 zu interpretieren. Alle anderen Befunde sind dagegen zwar absolut typisch bei COVID-19, können grundsätzlich aber auch bei anderen pulmonalen Erkrankungen erhoben werden, was die Sensitivität der Lungensonografie für die Diagnose von COVID-19 einerseits limitiert, andererseits bei hoher Spezifität gut zum Ausschluss der Erkrankung herangezogen werden kann [18].…”

“…Although all the other findings are completely typical with COVID-19, in principle they can also occur with other pulmonary diseases. While that limits the sensitivity of lung sonography for the diagnosis of COVID-19 on the one hand, on the other hand if the specificity is high, it can be used to exclude COVID-19 18 .…”

Modality alignment contrastive learning for severity assessment of COVID-19 from lung ultrasound and clinical information

“…In summary, LUS can be used for 1) diagnosing symptomatic patients ( Buonsenso, Raffaelli, Tamburrini, Biasucci, Salvi, Smargiassi, Inchingolo, Scambia, Lanzone, Testa, Moro, 2020b , Poggiali, Dacrema, Bastoni, Tinelli, Demichele, Ramos, Marcianò, Silva, Vercelli, Magnacavallo, 2020 , Bar, Lecourtois, Diouf, Goldberg, Bourbon, Arnaud, Domisse, Dupont, Gosset, 2020 ), 2) prognostic stratification and monitoring ( Buonsenso, Raffaelli, Tamburrini, Biasucci, Salvi, Smargiassi, Inchingolo, Scambia, Lanzone, Testa, Moro, 2020b , Tung-Chen, 2020 ), 3) management of ICU patients with regard to treatment resources ( Via, Storti, Gulati, Neri, Mojoli, Braschi, 2012 , Volpicelli, Lamorte, Villén, 2020 ), and 4) monitoring the effect of therapeutic measures ( Via, Storti, Gulati, Neri, Mojoli, Braschi, 2012 , Tung-Chen, 2020 , Soldati, Smargiassi, Inchingolo, Buonsenso, Perrone, Briganti, Perlini, Torri, Mariani, Mossolani, et al., 2020b ). Besides, LUS is also a favorable techinique for pregnant women and children ( Buonsenso et al., 2020a ).…”