Quarato Carla Maria Irene, Mirijello Antonio, Lacedonia Donato, Russo Raffaele, Maggi Michele Maria, Rea Gaetano, Simeone Annalisa, Borelli Cristina, Feragalli Beatrice, Scioscia Giulia, Barbaro Maria Pia Foschino, Massa Valentina, De Cosmo Salvatore, Sperandeo Marco
COVID-19 Center, Policlinico "Riuniti" di Foggia, Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, University of Foggia, 71100 Foggia, Italy.
COVID-19 Unit, Department of Medical Sciences, IRCCS Fondazione Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy.
Medicina (Kaunas). 2021 Mar 4;57(3):236. doi: 10.3390/medicina57030236.
: The potential role of lung ultrasound (LUS) in characterizing lung involvement in Coronavirus disease 2019 (COVID-19) is still debated. The aim of the study was to estimate sensitivity of admission LUS for the detection of SARS-CoV-2 lung involvement using Chest-CT (Computed Tomography) as reference standard in order to assess LUS usefulness in ruling out COVID-19 pneumonia in the Emergency Department (ED). : Eighty-two patients with confirmed COVID-19 and signs of lung involvement on Chest-CT were consecutively admitted to our hospital and recruited in the study. Chest-CT and LUS examination were concurrently performed within the first 6-12h from admission. Sensitivity of LUS was calculated using CT findings as a reference standard. : Global LUS sensitivity in detecting COVID-19 pulmonary lesions was 52%. LUS sensitivity ranged from 8% in case of focal and sporadic ground-glass opacities (mild disease), to 52% for a crazy-paving pattern (moderate disease) and up to 100% in case of extensive subpleural consolidations (severe disease), although LUS was not always able to detect all the consolidations assessed at Chest-CT. LUS sensitivity was higher in detecting a typical Chest-CT pattern (60%) and abnormalities showing a middle-lower zone predominance (79%). : As admission LUS may result falsely negative in most cases, it should not be considered as a reliable imaging tool in ruling out COVID-19 pneumonia in patients presenting in ED. It may at least represent an expanded clinical evaluation that needs integration with other diagnostic tests (e.g., nasopharyngeal swab, Chest-CT).
肺部超声（LUS）在判定2019冠状病毒病（COVID-19）肺部受累情况方面的潜在作用仍存在争议。本研究旨在以胸部计算机断层扫描（CT）作为参考标准，评估入院时LUS检测严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）肺部受累的敏感性，以评估LUS在急诊科（ED）排除COVID-19肺炎中的作用。：82例确诊COVID-19且胸部CT有肺部受累征象的患者连续入住我院并纳入本研究。胸部CT和LUS检查在入院后的前6 - 12小时内同时进行。以CT检查结果作为参考标准计算LUS的敏感性。：LUS检测COVID-19肺部病变的总体敏感性为52%。LUS的敏感性范围为：局灶性和散在性磨玻璃影（轻症）时为8%，铺路石样改变（中度疾病）时为52%，广泛的胸膜下实变（重症）时高达100%，尽管LUS并非总能检测出胸部CT评估的所有实变。LUS检测典型胸部CT表现（60%）以及以中下肺区为主的异常表现（79%）时敏感性更高。：由于入院时LUS在大多数情况下可能出现假阴性，因此在排除急诊科就诊患者的COVID-19肺炎时，不应将其视为可靠的影像学工具。它至少可以作为一种扩展的临床评估，需要与其他诊断检查（如鼻咽拭子、胸部CT）相结合。
