Comparison of lung ultrasound versus chest x-ray for detection of pulmonary infiltrates in covid-19

María Mateos González, Gonzalo García de Casasola Sánchez, Francisco Javier Teigell Muñoz, Kevin Proud, Davide Lourdo, Julia Verena Sander, Gabriel E.Ortiz Jaimes, Michael Mader, Jesús Canora Lebrato, Marcos I. Restrepo, Nilam J. Soni

Research output: Contribution to journalArticlepeer-review

Abstract

Point-of-care lung ultrasound (LUS) is an attractive alternative to chest X-ray (CXR), but its diagnostic accuracy compared to CXR has not been well studied in coronavirus disease 2019 (COVID-19) patients. We conducted a prospective observational study to assess the correlation between LUS and CXR findings in COVID-19 patients. Ninety-six patients with a clinical diagnosis of COVID-19 underwent an LUS exam and CXR upon presentation. Physicians blinded to the CXR findings performed all LUS exams. Detection of pulmonary infiltrates by CXR versus LUS was compared between patients categorized as suspected or confirmed COVID-19 based on reverse transcriptase-polymerase chain reaction. Sensitivities and correlation by Kappa statistic were calculated between LUS and CXR. LUS detected pulmonary infiltrates more often than CXR in both suspected and confirmed COVID-19 subjects. The most common LUS abnormalities were discrete B-lines, confluent B-lines, and small subpleural consolidations. Most important, LUS detected unilateral or bilateral pulmonary infiltrates in 55% of subjects with a normal CXR. Substantial agreement was demonstrated between LUS and CXR for normal, unilateral or bilateral findings (K = 0.48 (95% CI 0.34 to 0.63)). In patients with suspected or confirmed COVID-19, LUS detected pulmonary infiltrates more often than CXR, including more than half of the patients with a normal CXR.

Original languageEnglish (US)
Article number373
JournalDiagnostics
Volume11
Issue number2
DOIs
StatePublished - Feb 2021

Keywords

  • Chest
  • Diagnosis
  • Imaging
  • SARS
  • Ultrasound
  • X-ray

ASJC Scopus subject areas

  • Clinical Biochemistry

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