Lung Ultrasound vs Chest CT for Diagnosis of COVID-19 Pneumonia
Lung ultrasound offers a non-invasive and effective diagnostic tool to monitor the course and stratify the prognosis of patients with COVID-19 pneumonia, according to the results of a study published in Respiratory survey.
The researchers sought to assess the diagnostic accuracy of lung ultrasound (LUS) compared to chest computed tomography (CT) in determining the severity of COVID-19 pneumonia. They also hoped to show correlations between the LUS score, percutaneous oxygen saturation (SpO2), and inflammatory markers.
Researchers conducted a prospective observational study at the Târgu-Mureș Pneumology Clinic, Mureș County Clinical Hospital, Romania, between January 2021 and March 2021. The study analyzed data from 48 adult patients diagnosed with severe acute SARS-CoV-2 infection and clinically active disease. respiratory infection. All participants underwent LUS, CT and blood tests upon admission.
The researchers found that the LUS had subpleural consolidations (70.8%), pleural irregularities with thickening/discontinuity (75%), and bilateral B-lines (97.8%). Uncommon ultrasound patterns were alveolar consolidation with pleural effusion (2%) and bronchogram (33%). They noted that LUS score cutoff values of 14 or less and greater than 22 predicted mild COVID-19 (susceptibility [Se]=84.6%; area under the curve [AUC]=0.72; P = 0.002) and severe COVID-19 (Se = 50%, specificity (Sp) = 91.2%, AUC = 0.69; P = 0.02), respectively, and values greater than 29 predicted transfer of patients to ICU (Se = 80%, Sp = 97.7%).
According to the researchers, the LUS score is positively correlated with the CT score (r = 0.41; P =.003) and increased with decreasing SpO2 (r= -0.49; P =.003), with decline in lymphocytes (r= -0.52; P =.0001). They added that patients with consolidation patterns had higher C-reactive protein and ferritin than those with B-line patterns (P =.03; P =.01, respectively).
Limitations of the study include observational nature without randomization or blinding, small sample size, selection bias, and lack of a convex transducer.
The researchers concluded that “the LUS is a useful, non-invasive, and effective tool for the diagnosis, course monitoring, and prognostic stratification of COVID-19 patients.” They added that “LUS had good diagnostic accuracy, evidenced by higher sensitivity and specificity in detecting COVID-19 severity types and predicting critical patient transfer to intensive care.”
Disclosure: Some study authors have disclosed affiliations with biotechnology, pharmaceutical and/or device companies. Please see the original citation for a full list of author disclosures.
Ciurba BE, Sárközi HK, Szabó IA, et al. Applicability of lung ultrasound in the evaluation of COVID-19 pneumonia: diagnostic accuracy and clinical correlations. Breathe survey. Published online August 8, 2022. doi:10.1016/j.resinv.2022.06.015