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

Détails

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_AAD8421B1695
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Point-of-care lung ultrasonography for early identification of mild COVID-19: a prospective cohort of outpatients in a Swiss screening center.
Périodique
BMJ open
Auteur⸱e⸱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
Statut éditorial
Publié
Date de publication
24/06/2022
Peer-reviewed
Oui
Volume
12
Numéro
6
Pages
e060181
Langue
anglais
Notes
Publication types: Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Résumé
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.
Mots-clé
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
Web of science
Open Access
Oui
Création de la notice
04/07/2022 13:20
Dernière modification de la notice
11/03/2023 6:44
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