Higher Accuracy of Lung Ultrasound over Chest X-ray for Early Diagnosis of COVID-19 Pneumonia
| Autor: | Jose María Palacín Peruga, Cristina García Serrano, Jesús Pujol Salud, Marta Ortega Bravo, Javier Martínez Redondo, Montserrat Crespo Pons, Carles Comas Rodríguez |
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| Předmět: |
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19) Health Toxicology and Mutagenesis Lung ultrasonography lcsh:Medicine Sensitivity and Specificity Article 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine McNemar's test medicine Humans 030212 general & internal medicine Thoracic radiography Lung Pandemics Retrospective Studies general practice business.industry SARS-CoV-2 X-Rays lcsh:R Public Health Environmental and Occupational Health Interstitial lung disease COVID-19 Retrospective cohort study lung ultrasonography medicine.disease Lung ultrasound Pneumonia thoracic radiography medicine.anatomical_structure Early Diagnosis Spain Radiology business Tomography X-Ray Computed General practice Interstitial Disease |
| Zdroj: | Recercat. Dipósit de la Recerca de Catalunya instname International Journal of Environmental Research and Public Health, Vol 18, Iss 3481, p 3481 (2021) International Journal of Environmental Research and Public Health Recercat: Dipósit de la Recerca de Catalunya Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) Volume 18 Issue 7 Repositorio Abierto de la UdL Universitad de Lleida |
| Popis: | Background: The COVID-19 pandemic rapidly strained healthcare systems worldwide. The reference standard for diagnosis is a positive reverse transcription polymerase chain reaction (RT-PCR) test, but results are not immediate and sensibility is variable. Aim: To evaluate the diagnostic accuracy of lung ultrasound compared to chest X-ray for COVID-19 pneumonia. Design and Setting: A retrospective analysis of symptomatic patients admitted into one primary care centre in Spain between March and September 2020. Method: Patients’ chest X-rays and lung ultrasounds were categorized as normal or pathologic. RT-PCR confirmed COVID-19 infection. Pathologic lung ultrasound images were further categorized as showing either local or diffuse interstitial disease. McNemar and Fisher tests were used to compare diagnostic accuracy. Results: Most of the 212 patients presented fever at admission, either as a standalone symptom (37.74% of patients) or together with others (72.17% of patients). The positive predictive value of the lung ultrasound was 90% for the diffuse interstitial pattern and 46.92% for local pattern. The lung ultrasound had a significantly higher sensitivity (82.75%) (p < 0.001), but lower specificity (71%) than the chest X-ray (54.02% and 86%, respectively) (p = 0.008) for identifying interstitial lung disease. Moreover, sensitivity of the lung ultrasound for severe interstitial disease was 100%, and was significantly higher than the chest X-ray (58.33%) (p = 0.002). Conclusion: The lung ultrasound is more accurate than the chest X-ray for identifying patients with COVID-19 pneumonia and it is especially useful for those presenting diffuse interstitial disease. |
| Databáze: | OpenAIRE |
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