Department of Emergency Medicine, University Hospital of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Heart Center Freiburg University, Department of Cardiology and Angiology I, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
BMC Emerg Med. 2020 Dec 7;20(1):96. doi: 10.1186/s12873-020-00389-w.
Typical lung ultrasound (LUS) findings in patients with a COVID-19 infection were reported early on. During the global SARS-CoV-2 pandemic, LUS was propagated as a useful instrument in triage and monitoring. We evaluated LUS as a rapid diagnostic triage tool for the management of patients with suspected COVID-19 in the emergency department (ED).
The study retrospectively enrolled patients with suspected COVID-19, who were admitted from 1st April to 25th of April 2020 to the ED of a tertiary care center in Germany. During clinical work-up, patients underwent LUS and polymerase chain reaction (PCR) testing for SARS-CoV-2. The recorded ultrasound findings were analyzed and judged regarding typical signs of viral pneumonia, blinded for clinical information of the patients. The results were compared with PCR test and chest computed tomography (CT).
2236 patients were treated in the ED during the study period. 203 were tested for SARS-CoV-2 using PCR, 135 (66.5%) underwent LUS and 39 (28.9%) of the patients were examined by chest CT scan. 39 (28.9%) of the 135 patients were tested positive for SARS-CoV-2 with PCR. In 52 (38.5%) COVID-19 was suspected from the finding of the LUS, resulting in a sensitivity of 76.9% and a specificity of 77.1% compared with PCR results. The negative predictive value reached 89.2%. The findings of the LUS had - compared to a positive chest CT scan for COVID-19 - a sensitivity of 70.6% and a specificity of 72.7%.
LUS is a rapid and useful triage tool in the work-up of patients with suspected COVID-19 infection during a pandemic scenario. Still, the results of the LUS depend on the physician's experience and skills.
COVID-19 感染患者的典型肺部超声（LUS）表现已早有报道。在全球 SARS-CoV-2 大流行期间，LUS 被推广为分诊和监测的有用工具。我们评估了 LUS 作为一种快速诊断分诊工具，用于管理急诊科（ED）疑似 COVID-19 患者。
本研究回顾性纳入了 2020 年 4 月 1 日至 4 月 25 日期间因疑似 COVID-19 而收入德国一家三级护理中心 ED 的患者。在临床评估期间，患者接受了 LUS 和 SARS-CoV-2 的聚合酶链反应（PCR）检测。分析记录的超声结果，并根据病毒性肺炎的典型征象进行判断，对患者的临床信息进行盲法评估。结果与 PCR 检测和胸部计算机断层扫描（CT）进行比较。
研究期间，ED 共收治 2236 例患者。203 例接受 SARS-CoV-2 PCR 检测，135 例行 LUS（66.5%），39 例行胸部 CT 扫描（28.9%）。39 例患者的 PCR 检测结果为 SARS-CoV-2 阳性（28.9%）。52 例（38.5%）患者根据 LUS 检查结果怀疑为 COVID-19，与 PCR 结果相比，其灵敏度为 76.9%，特异性为 77.1%。阴性预测值为 89.2%。与 COVID-19 阳性胸部 CT 扫描相比，LUS 的灵敏度为 70.6%，特异性为 72.7%。
在大流行背景下，LUS 是一种快速且有用的分诊工具，可用于疑似 COVID-19 感染患者的评估。然而，LUS 的结果仍取决于医生的经验和技能。
