Point-of-care lung ultrasonography for early identification of mild COVID-19: a prospective cohort of outpatients in a Swiss screening center.

Details

Serval ID
serval:BIB_AAD8421B1695
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Point-of-care lung ultrasonography for early identification of mild COVID-19: a prospective cohort of outpatients in a Swiss screening center.
Journal
BMJ open
Author(s)
Schaad S., Brahier T., Hartley M.A., Cordonnier J.B., Bosso L., Espejo T., Pantet O., Hugli O., Carron P.N., Meuwly J.Y., Boillat-Blanco N.
ISSN
2044-6055 (Electronic)
ISSN-L
2044-6055
Publication state
Published
Issued date
24/06/2022
Peer-reviewed
Oui
Volume
12
Number
6
Pages
e060181
Language
english
Notes
Publication types: Journal Article ; Observational Study
Publication Status: epublish
Abstract
Early identification of SARS-CoV-2 infection is important to guide quarantine and reduce transmission. This study evaluates the diagnostic performance of lung ultrasound (LUS), an affordable, consumable-free point-of-care tool, for COVID-19 screening.
This prospective observational cohort included adults presenting with cough and/or dyspnoea at a SARS-CoV-2 screening centre of Lausanne University Hospital between 31 March and 8 May 2020.
Investigators recorded standardised LUS images and videos in 10 lung zones per patient. Two blinded independent experts reviewed LUS recording and classified abnormal findings according to prespecified criteria to investigate their predictive value to diagnose SARS-CoV-2 infection according to PCR on nasopharyngeal swabs (COVID-19 positive vs COVID-19 negative).
We finally combined LUS and clinical findings to derive a multivariate logistic regression diagnostic score.
Of 134 included patients, 23% (n=30/134) were COVID-19 positive and 77% (n=103/134) were COVID-19 negative; 85%, (n=114/134) cases were previously healthy healthcare workers presenting within 2-5 days of symptom onset (IQR). Abnormal LUS findings were significantly more frequent in COVID-19 positive compared with COVID-19 negative (45% vs 26%, p=0.045) and mostly consisted of focal pathologic B lines. Combining clinical findings in a multivariate logistic regression score had an area under the receiver operating curve of 80.3% to detect COVID-19, and slightly improved to 84.5% with the addition of LUS features.
COVID-19-positive patients are significantly more likely to have lung pathology by LUS. However, LUS has an insufficient sensitivity and is not an appropriate screening tool in outpatients. LUS only adds little value to clinical features alone.
Keywords
Adult, COVID-19/diagnostic imaging, Humans, Lung/diagnostic imaging, Outpatients, Point-of-Care Systems, Prospective Studies, SARS-CoV-2, Switzerland/epidemiology, Ultrasonography/methods, COVID-19, diagnostic radiology, infectious diseases, ultrasonography
Pubmed
Open Access
Yes
Create date
04/07/2022 14:20
Last modification date
21/07/2022 6:36
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