Lung injury in patients with or suspected COVID-19 : a comparison between lung ultrasound and chest CT-scanner severity assessments, an observational study

Benchoufi, Mehdi; Bokobza, J.; Chauvin, Anthony; Dion, Élisabeth; Baranne, Marie-Laure; Levan, Fabien; Gautier, Maxime; Cantin, D.; d’Humières, Thomas; Gil‐Jardine, Cédric; Benenati, Sylvain; Orbelin, Mathieu; Martinez, M.; Pierre-Kahn, N.; Diallo, Abdourahmane; Vicaut, Eric; Bourrier, Pierre

doi:10.1101/2020.04.24.20069633

Cited by 17 publications

(28 citation statements)

References 20 publications

(18 reference statements)

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“…[23][24][25] Scanning techniques, and images of patients with proven COVID-19 have spread among clinicians on Twitter and blogs 26,27 among others, and at least one COVID-19 ultrasound scoring system has been proposed. 28 LUS has emerged as a clinical tool in human and veterinary medicine and in animal research with some advocates calling for it to replace the stethoscope. [29][30][31][32] Others have shown ultrasound to complement rather than Table 2.…”

Section: Discussionmentioning

confidence: 99%

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Point-of-care Lung Ultrasound Is Useful to Evaluate Emergency Department Patients for COVID-19

Walsh

Hankins

Bang

2020

WestJEM

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Section: Discussionmentioning

confidence: 99%

“…Much more detailed and formalized LUS protocols and ultrasound scoring systems specifically for use in SARS-CoV-2 patients have been described. 28,35 Abbreviated protocols are inevitable in community practice and could lead to missed diagnoses. This would have biased our study in the opposite direction of our actual findings.…”

Section: Limitationsmentioning

confidence: 99%

Point-of-care Lung Ultrasound Is Useful to Evaluate Emergency Department Patients for COVID-19

Walsh

Hankins

Bang

2020

WestJEM

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Section: Comparison Of Lus To a Reference Standard (Ct)mentioning

confidence: 99%

“…Benchoufi et al 33 and Lu et al 34 both examined whether LUS could accurately predict severity of disease on CT. In Benchoufi's study, 33 107 adult patients presenting to ED with suspected COVID-19 were included, 86 of whom tested positive. When LUS was considered as a four-category ordinal scale of severity, there was moderate agreement with CT, kappa 0.52 (0.38-0.66), however, when this was reduced to a binary outcome (normal vs. pathologic) there was strong correlation (sensitivity 95%, specificity 83%).…”

Section: Comparison Of Lus To a Reference Standard (Ct)mentioning

confidence: 99%

“…Operator experience may also affect specificity as an expert will be able to better correlate different LUS patterns with different disease processes. Benchoufi et al, 33 state that specificity was 83%, however, this was based on the LUS being simply normal or pathologic. Peyrony et al 36 achieved a slightly higher specificity of 89%, however, this was based on only the presence of bilateral B lines.…”

Section: Comparison Of Lus To a Reference Standardmentioning

confidence: 99%

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

et al. 2020

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Introduction Lung ultrasound (LUS) has an established evidence base and has proven useful in previous viral epidemics. An understanding of the utility of LUS in COVID-19 is crucial to determine its most suitable role based on local circumstances. Method Online databases, specialist websites and social media platforms were searched to identify studies that explore the utility of LUS in COVID-19. Case reports and recommendations were excluded. Findings In total, 33 studies were identified which represent a rapidly expanding evidence base for LUS in COVID-19. The quality of the included studies was relatively low; however, LUS certainly appears to be a highly sensitive and fairly specific test for COVID-19 in all ages and in pregnancy. Discussion There may be LUS findings and patterns that are relatively specific to COVID-19; however, specificity may also be influenced by factors such as disease severity, pre-existing lung disease, operator experience, disease prevalence and the reference standard. Conclusion LUS is almost certainly more sensitive than chest radiograph for COVID-19 and has several advantages over computed tomography and real-time polymerase chain reaction. High-quality research is needed into various aspects of LUS including: diagnostic accuracy in undifferentiated patients; triage and prognostication; monitoring progression and guiding interventions; the persistence of residual LUS findings; inter-observer agreement and the role of contrast-enhanced LUS.

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Lung Ultrasonography for COVID-19 Patients in Out of Hospital Settings

et al. 2022

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Purpose The portability of a hand-held ultrasound allows the health care worker to conduct lung ultrasound in out-of-hospital setting. It is used as a tool to conduct staging and triaging for COVID-19 patients. This study evaluated the utilization of lung ultrasound in an out-of-hospital setting versus chest x-rays in detecting and staging of COVID-19 patients with pneumonia. Methods The study was conducted among COVID-19 subjects at an out-of-hospital setting whereby lung ultrasound was done and subsequently chest x-rays were taken after being admitted to the health care facilities. Lung ultrasound findings were reviewed by emergency physicians, while the chest x-rays were reviewed by radiologists. Radiologists were blinded by the patients’ lung ultrasound findings and clinical conditions. The analysis of the agreement between the lung ultrasound findings and chest x-rays was conducted. Results A total of 261 subjects were recruited. LUS detected pulmonary infiltrative changes in more stage 3 COVID-19 subjects in comparison to chest x-rays. Multiple B-lines were the predominant findings at the right lower anterior, posterior and lateral zones. Interstitial consolidations and ground glass opacities were the predominant descriptive findings in chest x-rays. However, there was no agreement between lung ultrasound and chest x-ray findings in detecting COVID-19 pneumonia as the Cohen’s Kappa coefficient was 0.08 (95% CI 0.06–0.22, p = 0.16). Conclusion The diagnostic imaging and staging of COVID-19 patients using lung ultrasound in out-of-hospital settings showed LUS detected lung pleural disease more often than CXR for stage 3 COVID-19 patients.

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Lung injury in patients with or suspected COVID-19 : a comparison between lung ultrasound and chest CT-scanner severity assessments, an observational study

Abstract: Background: Chest CT (CT) is the reference for assessing pulmonary injury in suspected or diagnosed COVID-19 with signs of clinical severity. We explored the role of lung ultrasonography (LU) in quickly assessing lung status in these patients.

Cited by 17 publications

References 20 publications

Point-of-care Lung Ultrasound Is Useful to Evaluate Emergency Department Patients for COVID-19

Point-of-care Lung Ultrasound Is Useful to Evaluate Emergency Department Patients for COVID-19

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

Lung Ultrasonography for COVID-19 Patients in Out of Hospital Settings

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