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Correlation between Chest Computed Tomography and Lung Ultrasonography in Patients with Coronavirus Disease 2019 (COVID-19).
Ultrasound Med Biol. 2020 11; 46(11):2918-2926.UM

Abstract

There is growing evidence regarding chest X-ray and computed tomography (CT) findings for coronavirus disease 2019 (COVID-19). At present, the role of lung ultrasonography (LUS) has yet to be explored. The main purpose of this study was to evaluate the correlation between LUS findings and chest CT in patients confirmed to have (positive reverse transcription polymerase chain reaction [RT-PCR]) or clinically highly suspected of having (dyspnea, fever, myasthenia, gastrointestinal symptoms, dry cough, ageusia or anosmia) COVID-19. This prospective study was carried out in the emergency department, where patients confirmed of having or clinically highly suspected of having COVID-19 were recruited and underwent chest CT and concurrent LUS exam. An experienced emergency department physician performed the LUS exam blind to the clinical history and results of the CT scan, which were reviewed by two radiologists in consensus for signs compatible with COVID-19 (bilateral ground-glass opacities in peripheral distribution). A compatible LUS exam was considered a bilateral pattern of B-lines, irregular pleural line and subpleural consolidations. Between March and April 2020, 51 patients were consecutively enrolled. The indication for CT was a negative or indeterminate RT-PCR test (49.0%) followed by suspicion of pulmonary embolism (41.2%). Radiologic signs compatible with COVID-19 were present in 37 patients (72.5%) on CT scan and 40 patients (78.4%) on LUS exam. The presence of LUS findings was correlated with a positive CT scan suggestive of COVID-19 (odds ratio: 13.3, 95% confidence interval: 4.5-39.6, p < 0.001) with a sensitivity of 100.0%, specificity of 78.6%, positive predictive value of 92.5% and negative predictive value of 100.0%. There was no missed diagnosis of COVID-19 with LUS compared with CT in our cohort. The correlation between LUS score and CT total severity score was good (intraclass correlation coefficient: 0.803, 95% confidence interval: 0.60-0.90, p < 0.001). LUS exhibited similar accuracy compared with chest CT in the detection of lung abnormalities in COVID-19 patients.

Authors+Show Affiliations

Department of Emergency Medicine, Hospital Universitario La Paz, Madrid, Spain. Electronic address: yale.tung@salud.madrid.org.Department of Emergency Radiology, Hospital Universitario de La Paz, Madrid, Spain.Department of Emergency Radiology, Hospital Universitario de La Paz, Madrid, Spain.Department of Emergency Radiology, Hospital Universitario de La Paz, Madrid, Spain.Department of Emergency Radiology, Hospital Universitario de La Paz, Madrid, Spain.Department of Emergency Radiology, Hospital Universitario de La Paz, Madrid, Spain.Department of Emergency Radiology, Hospital Universitario de La Paz, Madrid, Spain.Department of Emergency Medicine, Hospital Universitario La Paz, Madrid, Spain.Department of Emergency Medicine, Hospital Universitario Reina Sofía, Cordoba, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32771222

Citation

Tung-Chen, Yale, et al. "Correlation Between Chest Computed Tomography and Lung Ultrasonography in Patients With Coronavirus Disease 2019 (COVID-19)." Ultrasound in Medicine & Biology, vol. 46, no. 11, 2020, pp. 2918-2926.
Tung-Chen Y, Martí de Gracia M, Díez-Tascón A, et al. Correlation between Chest Computed Tomography and Lung Ultrasonography in Patients with Coronavirus Disease 2019 (COVID-19). Ultrasound Med Biol. 2020;46(11):2918-2926.
Tung-Chen, Y., Martí de Gracia, M., Díez-Tascón, A., Alonso-González, R., Agudo-Fernández, S., Parra-Gordo, M. L., Ossaba-Vélez, S., Rodríguez-Fuertes, P., & Llamas-Fuentes, R. (2020). Correlation between Chest Computed Tomography and Lung Ultrasonography in Patients with Coronavirus Disease 2019 (COVID-19). Ultrasound in Medicine & Biology, 46(11), 2918-2926. https://doi.org/10.1016/j.ultrasmedbio.2020.07.003
Tung-Chen Y, et al. Correlation Between Chest Computed Tomography and Lung Ultrasonography in Patients With Coronavirus Disease 2019 (COVID-19). Ultrasound Med Biol. 2020;46(11):2918-2926. PubMed PMID: 32771222.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlation between Chest Computed Tomography and Lung Ultrasonography in Patients with Coronavirus Disease 2019 (COVID-19). AU - Tung-Chen,Yale, AU - Martí de Gracia,Milagros, AU - Díez-Tascón,Aurea, AU - Alonso-González,Rodrigo, AU - Agudo-Fernández,Sergio, AU - Parra-Gordo,Maria Luz, AU - Ossaba-Vélez,Silvia, AU - Rodríguez-Fuertes,Pablo, AU - Llamas-Fuentes,Rafael, Y1 - 2020/07/13/ PY - 2020/05/21/received PY - 2020/06/22/revised PY - 2020/07/04/accepted PY - 2020/8/11/pubmed PY - 2020/10/2/medline PY - 2020/8/11/entrez KW - COVID-19 KW - Chest computed tomography KW - Coronavirus disease 2019 KW - SARS-CoV-2 Lung ultrasonography KW - Severe acute respiratory syndrome coronavirus 2 SP - 2918 EP - 2926 JF - Ultrasound in medicine & biology JO - Ultrasound Med Biol VL - 46 IS - 11 N2 - There is growing evidence regarding chest X-ray and computed tomography (CT) findings for coronavirus disease 2019 (COVID-19). At present, the role of lung ultrasonography (LUS) has yet to be explored. The main purpose of this study was to evaluate the correlation between LUS findings and chest CT in patients confirmed to have (positive reverse transcription polymerase chain reaction [RT-PCR]) or clinically highly suspected of having (dyspnea, fever, myasthenia, gastrointestinal symptoms, dry cough, ageusia or anosmia) COVID-19. This prospective study was carried out in the emergency department, where patients confirmed of having or clinically highly suspected of having COVID-19 were recruited and underwent chest CT and concurrent LUS exam. An experienced emergency department physician performed the LUS exam blind to the clinical history and results of the CT scan, which were reviewed by two radiologists in consensus for signs compatible with COVID-19 (bilateral ground-glass opacities in peripheral distribution). A compatible LUS exam was considered a bilateral pattern of B-lines, irregular pleural line and subpleural consolidations. Between March and April 2020, 51 patients were consecutively enrolled. The indication for CT was a negative or indeterminate RT-PCR test (49.0%) followed by suspicion of pulmonary embolism (41.2%). Radiologic signs compatible with COVID-19 were present in 37 patients (72.5%) on CT scan and 40 patients (78.4%) on LUS exam. The presence of LUS findings was correlated with a positive CT scan suggestive of COVID-19 (odds ratio: 13.3, 95% confidence interval: 4.5-39.6, p < 0.001) with a sensitivity of 100.0%, specificity of 78.6%, positive predictive value of 92.5% and negative predictive value of 100.0%. There was no missed diagnosis of COVID-19 with LUS compared with CT in our cohort. The correlation between LUS score and CT total severity score was good (intraclass correlation coefficient: 0.803, 95% confidence interval: 0.60-0.90, p < 0.001). LUS exhibited similar accuracy compared with chest CT in the detection of lung abnormalities in COVID-19 patients. SN - 1879-291X UR - https://www.unboundmedicine.com/medline/citation/32771222/Correlation_between_Chest_Computed_Tomography_and_Lung_Ultrasonography_in_Patients_with_Coronavirus_Disease_2019__COVID_19__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-5629(20)30301-X DB - PRIME DP - Unbound Medicine ER -