Lung Assessment with Point-of-Care Ultrasound in Respiratory Coronavirus Disease (COVID-19): A Prospective Cohort Study

Ultrasound Med Biol. 2021 Apr;47(4):896-901. doi: 10.1016/j.ultrasmedbio.2020.12.021. Epub 2020 Dec 26.

Abstract

Lung ultrasound (LUS) has shown promising diagnostic potential in different pulmonary conditions. We evaluated the diagnostic accuracy of LUS for pulmonary COVID-19. In this prospective cohort study at a Swiss tertiary care center, patients hospitalized with suspected COVID-19 were scanned using a 12-zone protocol. Association of a summation score (0-36 points) with the final diagnosis was tested using the area under the receiver operating characteristic curve and sensitivity and specificity at different cutoff points. Of the 49 participants, 11 (22%) were later diagnosed with COVID-19. LUS score showed excellent diagnostic performance, with an odds ratio of 1.30 per point (95% confidence interval [CI], 1.09-1.54, p = 0.003) and an area under the curve of 0.85 (95% CI, 0.71-0.99). At a cutoff of 8/36 points, 10 of 11 participants later diagnosed with COVID-19 were correctly predicted (sensitivity 91%, 95% CI, 59%-100%), and 29 of the 38 who were not diagnosed with COVID-19 were correctly ruled out (specificity 76%, 95% CI, 60%-89%). LUS demonstrated promising discriminatory potential in people hospitalized with suspected COVID-19.

Keywords: COVID-19; Coronavirus disease; Interstitial syndrome; Lung ultrasound; Pleura ultrasound; Pneumonia; Point of care ultrasound; SARS-CoV-2.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / diagnostic imaging*
  • Cohort Studies
  • Female
  • Humans
  • Lung / diagnostic imaging*
  • Male
  • Middle Aged
  • Point-of-Care Systems*
  • Prospective Studies
  • Reproducibility of Results
  • SARS-CoV-2
  • Sensitivity and Specificity
  • Ultrasonography / methods*