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床边超声在呼吸冠状病毒病(COVID-19)中的肺部评估:一项前瞻性队列研究。

Lung Assessment with Point-of-Care Ultrasound in Respiratory Coronavirus Disease (COVID-19): A Prospective Cohort Study.

机构信息

Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Aarau, Switzerland; University Clinic of Internal Medicine, Kantonsspital Aarau, Aarau, Switzerland; Department of Emergency Medicine, Oberaargau Regional Hospital, Langenthal, Switzerland.

Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Aarau, Switzerland; University Clinic of Internal Medicine, Kantonsspital Aarau, Aarau, Switzerland.

出版信息

Ultrasound Med Biol. 2021 Apr;47(4):896-901. doi: 10.1016/j.ultrasmedbio.2020.12.021. Epub 2020 Dec 26.

Abstract

Lung ultrasound (LUS) has shown promising diagnostic potential in different pulmonary conditions. We evaluated the diagnostic accuracy of LUS for pulmonary COVID-19. In this prospective cohort study at a Swiss tertiary care center, patients hospitalized with suspected COVID-19 were scanned using a 12-zone protocol. Association of a summation score (0-36 points) with the final diagnosis was tested using the area under the receiver operating characteristic curve and sensitivity and specificity at different cutoff points. Of the 49 participants, 11 (22%) were later diagnosed with COVID-19. LUS score showed excellent diagnostic performance, with an odds ratio of 1.30 per point (95% confidence interval [CI], 1.09-1.54, p = 0.003) and an area under the curve of 0.85 (95% CI, 0.71-0.99). At a cutoff of 8/36 points, 10 of 11 participants later diagnosed with COVID-19 were correctly predicted (sensitivity 91%, 95% CI, 59%-100%), and 29 of the 38 who were not diagnosed with COVID-19 were correctly ruled out (specificity 76%, 95% CI, 60%-89%). LUS demonstrated promising discriminatory potential in people hospitalized with suspected COVID-19.

摘要

肺部超声(LUS)在不同的肺部疾病中显示出有希望的诊断潜力。我们评估了 LUS 在 COVID-19 肺部中的诊断准确性。在瑞士一家三级护理中心的这项前瞻性队列研究中,对因疑似 COVID-19 住院的患者使用 12 区方案进行扫描。使用接受者操作特征曲线下的面积以及不同截止点的灵敏度和特异性来测试总和评分(0-36 分)与最终诊断之间的关联。在 49 名参与者中,有 11 名(22%)后来被诊断为 COVID-19。LUS 评分显示出出色的诊断性能,每增加 1 分的优势比为 1.30(95%置信区间[CI],1.09-1.54,p=0.003),曲线下面积为 0.85(95%CI,0.71-0.99)。在 8/36 分的截止值下,后来被诊断为 COVID-19 的 11 名参与者中有 10 名被正确预测(敏感性为 91%,95%CI,59%-100%),而未被诊断为 COVID-19 的 38 名参与者中有 29 名被正确排除(特异性为 76%,95%CI,60%-89%)。LUS 显示出在因疑似 COVID-19 住院的人群中具有有前途的鉴别潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15b7/7834656/6080a328a7a0/gr1_lrg.jpg

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