BACKGROUND: Lung ultrasound (LUS) and chest radiography (CXR) are the most used chest imaging tools in the early diagnosis of COVID-19 associated pneumonia. However, the relationship between LUS and CXR is not clearly defined. The aim of our study was to describe the comparison between LUS interpretation and CXR readings in the first approach to patients suspected of COVID-19. METHODS: In the time of the first COVID-19 pandemic surge, we prospectively evaluated adult patients presenting to an emergency department complaining of symptoms raising suspicion of COVID-19. Patients were studied by LUS and only those performing also CXR were analyzed. All the patients performed viral reverse transcriptase-polymerase chain reaction (RT-PCR). LUS studies were classified in 4 categories of probabilities, based on the presence of typical or alternative signs of COVID-19-associated interstitial pneumonia. Accordingly, the CXR readings were retrospectively adapted by 2 experts in 4 categories following the standard language that describes the computed tomography (CT) findings. Patients were divided in two groups, based on the agreement of the LUS and CXR categories. Results were also compared to RT-PCR and, when available, to CT studies. RESULTS: We analyzed 139 cases (55 women, mean age 59.1 ± 15.5 years old). The LUS vs CXR results disagreed in 60 (43.2%) cases. RT-PCR was positive in 88 (63.3%) cases. In 45 cases, a CT scan was also performed and only 4 disagreed with LUS interpretation versus 24 in the comparison between CT and CXR. In 18 cases, LUS detected signs of COVID-19 pneumonia (high and intermediate probabilities) while CXR reading was negative; in 14 of these cases, a CT scan or a RT-PCR-positive result confirmed the LUS interpretation. In 6 cases, LUS detected signs of alternative diagnoses to COVID-19 pneumonia while CXR was negative; in 4 of these cases, CT scan confirmed atypical findings. CONCLUSION: Our study demonstrated a strong disagreement between LUS interpretation and CXR reading in the early approach to patients suspected of COVID-19. Comparison with CT studies and RT-PCR results seems to confirm the superiority of LUS over a second retrospective reading of CXR.
BACKGROUND: Lung ultrasound (LUS) and chest radiography (CXR) are the most used chest imaging tools in the early diagnosis of COVID-19 associated pneumonia. However, the relationship between LUS and CXR is not clearly defined. The aim of our study was to describe the comparison between LUS interpretation and CXR readings in the first approach to patients suspected of COVID-19. METHODS: In the time of the first COVID-19 pandemic surge, we prospectively evaluated adult patients presenting to an emergency department complaining of symptoms raising suspicion of COVID-19. Patients were studied by LUS and only those performing also CXR were analyzed. All the patients performed viral reverse transcriptase-polymerase chain reaction (RT-PCR). LUS studies were classified in 4 categories of probabilities, based on the presence of typical or alternative signs of COVID-19-associated interstitial pneumonia. Accordingly, the CXR readings were retrospectively adapted by 2 experts in 4 categories following the standard language that describes the computed tomography (CT) findings. Patients were divided in two groups, based on the agreement of the LUS and CXR categories. Results were also compared to RT-PCR and, when available, to CT studies. RESULTS: We analyzed 139 cases (55 women, mean age 59.1 ± 15.5 years old). The LUS vs CXR results disagreed in 60 (43.2%) cases. RT-PCR was positive in 88 (63.3%) cases. In 45 cases, a CT scan was also performed and only 4 disagreed with LUS interpretation versus 24 in the comparison between CT and CXR. In 18 cases, LUS detected signs of COVID-19 pneumonia (high and intermediate probabilities) while CXR reading was negative; in 14 of these cases, a CT scan or a RT-PCR-positive result confirmed the LUS interpretation. In 6 cases, LUS detected signs of alternative diagnoses to COVID-19 pneumonia while CXR was negative; in 4 of these cases, CT scan confirmed atypical findings. CONCLUSION: Our study demonstrated a strong disagreement between LUS interpretation and CXR reading in the early approach to patients suspected of COVID-19. Comparison with CT studies and RT-PCR results seems to confirm the superiority of LUS over a second retrospective reading of CXR.
Authors: Evgenii Shumilov; Ali Seif Amir Hosseini; Golo Petzold; Hannes Treiber; Joachim Lotz; Volker Ellenrieder; Steffen Kunsch; Albrecht Neesse Journal: Ultrasound Int Open Date: 2020-09-02
Authors: Nayaar Islam; Jean-Paul Salameh; Mariska Mg Leeflang; Lotty Hooft; Trevor A McGrath; Christian B van der Pol; Robert A Frank; Sakib Kazi; Ross Prager; Samanjit S Hare; Carole Dennie; René Spijker; Jonathan J Deeks; Jacqueline Dinnes; Kevin Jenniskens; Daniël A Korevaar; Jérémie F Cohen; Ann Van den Bruel; Yemisi Takwoingi; Janneke van de Wijgert; Junfeng Wang; Matthew Df McInnes Journal: Cochrane Database Syst Rev Date: 2020-11-26
Authors: Valentina Vespro; Maria Carmela Andrisani; Stefano Fusco; Letizia Di Meglio; Guido Plensich; Alice Scarabelli; Elvira Stellato; Anna Maria Ierardi; Luigia Scudeller; Andrea Coppola; Andrea Gori; Antonio Pesenti; Giacomo Grasselli; Stefano Aliberti; Francesco Blasi; Chiara Villa; Sonia Ippolito; Barbara Pirrò; Guglielmo Damiani; Massimo Galli; Giuliano Rizzardini; Emanuele Catena; Matteo Agostino Orlandi; Sandro Magnani; Giuseppe Cipolla; Andrea Antonio Ianniello; Mario Petrillo; Genti Xhepa; Antonio Scamporrino; Alberto Cazzulani; Gianpaolo Carrafiello Journal: Intern Emerg Med Date: 2020-11-20 Impact factor: 3.397
Authors: Arthur W E Lieveld; Bram Kok; Kaoutar Azijli; Frederik H Schuit; Peter M van de Ven; Chris L de Korte; Robin Nijveldt; Frederik M A van den Heuvel; Bernd P Teunissen; Wouter Hoefsloot; Prabath W B Nanayakkara; Frank H Bosch Journal: J Am Coll Emerg Physicians Open Date: 2021-05-01