Correlation between Lung Ultrasound and Chest CT in COVID-19 Pneumonia Patients on Hospital admission

Document Type : Original papers

Authors

1 Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt

2 Chest Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt

3 Vascular Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt

4 Radiodiagnosis Department, Faculty of Medicine, Tanta University, Tanta, Egypt

Abstract

Purpose: This study aimed to assess capability of lung ultrasound to distinguish different pulmonary patterns of COVID-19 and compare it to chest CT. Materials and Methods: This is a prospective randomized controlled study carried upon sixty-five patients from beginning of November 2021 to the end of October 2022 admitted to Isolation Hospital for COVID -19 patients and in isolation ward in Tanta Emergency Department. Results: Lung Ultrasound can significantly predict mild to moderate COVID-19 pneumonia (P=0.003 and AUC=0.704) with 98.04% sensitivity, 42.86 %specificity, 86.2% PPV and 85.7% NPV and severe COVID-19 pneumonia (P=<0.001 and AUC=0.885) with 92.00% sensitivity, 85.00% specificity, 79.3% PPV and 94.4% NPV. By dividing the patients into two groups according to Computed Tomography Severity Score and Lung Ultrasound Scoring System, there was a substantial agreement between CTSS and LUSS (P value<0.001, Kappa = 0.632). Conclusions: Lung ultrasound can substitute CT chest in predicting, screening and diagnosis of COVID-19 pneumonia.

Keywords

References

  1.  

    1. Lai CC, Shih TP, Ko WC, et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020;55:105924. https://doi.org/10.1016/j.ijantimicag.2020.105924
    2. Allinovi M, Parise A, Giacalone M, et al. Lung Ultrasound May Support Diagnosis and Monitoring of COVID-19 Pneumonia. Ultrasound Med Biol. 2020;46:2908-17. https://doi.org/10.1016/j.ultrasmedbio.2020.07.018
    3. Orlandi M, Lepri G, Bruni C, et al. The systemic sclerosis patient in the COVID-19 era: the challenging crossroad between immunosuppression, differential diagnosis and long-term psychological distress. Clin Rheumatol. 2020;39:2043-7. https://doi.org/10.1007/s10067-020-05193-2
    4. Ramdani H, Allali N, Chat L, et al. Covid-19 imaging: A narrative review. Ann Med Surg (Lond). 2021;69:102489. https://doi.org/10.1016/j.amsu.2021.102489
    5. Lepri G, Orlandi M, Lazzeri C, et al. The emerging role of lung ultrasound in COVID-19 pneumonia. Eur J Rheumatol. 2020;7:S129-s33. https://doi.org/10.5152/eurjrheum.2020.2063
    6. Lu W, Zhang S, Chen B, et al. A Clinical Study of Noninvasive Assessment of Lung Lesions in Patients with Coronavirus Disease-19 (COVID-19) by Bedside Ultrasound. Ultraschall Med. 2020;41:300-7. https://doi.org/10.1055/a-1154-8795
    7. Brahier T, Meuwly JY, Pantet O, et al. Lung Ultrasonography for Risk Stratification in Patients with Coronavirus Disease 2019 (COVID-19): A Prospective Observational Cohort Study. Clin Infect Dis. 2021;73:e4189-e96. https://doi.org/10.1093/cid/ciaa1408
    8. Ragnoli B, Malerba M. Focus on the Potential Role of Lung Ultrasound in COVID-19 Pandemic: What More to Do? Int J Environ Res Public Health. 2020;17. https://doi.org/10.3390/ijerph17228398
    9. Bikdeli B, Madhavan MV, Jimenez D, et al. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020;75:2950-73. https://doi.org/10.1016/j.jacc.2020.04.031
    10. Yang R, Li X, Liu H, et al. Chest CT Severity Score: An Imaging Tool for Assessing Severe COVID-19. Radiol Cardiothorac Imaging. 2020;2:e200047. https://doi.org/10.1148/ryct.2020200047
    11. Prokop M, van Everdingen W, van Rees Vellinga T, et al. CO-RADS: A Categorical CT Assessment Scheme for Patients Suspected of Having COVID-19-Definition and Evaluation. Radiology. 2020;296:E97-e104. https://doi.org/10.1148/radiol.2020201473
    12. Wangüemert Pérez AL, Figueira Gonçalves JM, Hernández Pérez JM, et al. Prognostic value of lung ultrasound and its link with inflammatory biomarkers in patients with SARS-CoV-2 infection. Respir Med Res. 2021;79:100809. https://doi.org/10.1016/j.resmer.2020.100809
    13. Acar H, Yamanoğlu A, Arıkan C, et al. Effectiveness of the CLUE protocol in COVID-19 triage. Cukurova Medical Journal. 2022;47:722-8.
    14. McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012;22:276-82.
    15. 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;46:2918-26. https://doi.org/10.1016/j.ultrasmedbio.2020.07.003
    16. Casella F, Barchiesi M, Leidi F, et al. Lung ultrasonography: A prognostic tool in non-ICU hospitalized patients with COVID-19 pneumonia. Eur J Intern Med. 2021;85:34-40. https://doi.org/10.1016/j.ejim.2020.12.012
    17. Schaad S, Brahier T, Hartley MA, et al. Point-of-care lung ultrasonography for early identification of mild COVID-19: a prospective cohort of outpatients in a Swiss screening center. BMJ Open. 2022;12:e060181. https://doi.org/10.1136/bmjopen-2021-060181
    18. Lopes AJ, Mafort TT, da Costa CH, et al. Comparison Between Lung Ultrasound and Computed Tomographic Findings in Patients With COVID-19 Pneumonia. J Ultrasound Med. 2021;40:1391-9. https://doi.org/10.1002/jum.15521
    19. Kosovalı BD, Çıvgın EY, Özkan E, et al. Clinical severity and mortality predictors in COVID-19 intensive care patients: CTSS and CO-RADS. Turkish Journal of Clinics and Laboratory. 2022;13:116-23.
    20. Du G, Wang Y, Chen Z, et al. Lung ultrasound correlates with radiographic severity and pattern in COVID-19 pneumonia: a preliminary study. Ann Palliat Med. 2021;10:8147-54. https://doi.org/10.21037/apm-21-1731
    21. Sahu AK, Mathew R, Bhoi S, et al. Lung sonographic findings in COVID-19 patients. Am J Emerg Med. 2021;45:324-8. https://doi.org/10.1016/j.ajem.2020.08.080
    22. Rizzetto F, Perillo N, Artioli D, et al. Correlation between lung ultrasound and chest CT patterns with estimation of pulmonary burden in COVID-19 patients. Eur J Radiol. 2021;138:109650. https://doi.org/10.1016/j.ejrad.2021.109650
    23. Portale G, Ciolina F, Arcari L, et al. Lung Ultrasound in COVID-19: Clinical Correlates and Comparison with Chest Computed Tomography. SN Compr Clin Med. 2021;3:2075-81. https://doi.org/10.1007/s42399-021-00986-1
    24. Bosso G, Allegorico E, Pagano A, et al. Lung ultrasound as diagnostic tool for SARS-CoV-2 infection. Intern Emerg Med. 2021;16:471-6. https://doi.org/10.1007/s11739-020-02512-y
    25. Ökmen K, Yıldız DK, Soyaslan E. Comparison of lung ultrasonography findings with chest computed tomography results in coronavirus (COVID-19) pneumonia. J Med Ultrason (2001). 2021;48:245-52. https://doi.org/10.1007/s10396-021-01081-7
    26. Chrzan R, Polok K, Antczak J, et al. The value of lung ultrasound in COVID-19 pneumonia, verified by high resolution computed tomography assessed by artificial intelligence. BMC Infect Dis. 2023;23:195. https://doi.org/10.1186/s12879-023-08173-4

     

     

The Egyptian Journal of Intensive Care and Emergency Medicine
Volume 5, Issue 1
January 2025
Pages 43-58

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