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肺部超声在新型冠状病毒肺炎中的应用:一项系统综述。

The utility of lung ultrasound in COVID-19: A systematic scoping review.

作者信息

Trauer Michael M, Matthies Ashley, Mani Nick, McDermott Cian, Jarman Robert

机构信息

Guy's and St Thomas' NHS Foundation Trust, London, UK.

University of Teesside, Middlesbrough, UK.

出版信息

Ultrasound. 2020 Nov;28(4):208-222. doi: 10.1177/1742271X20950779. Epub 2020 Aug 17.

Abstract

INTRODUCTION

Lung ultrasound (LUS) has an established evidence base and has proven useful in previous viral epidemics. An understanding of the utility of LUS in COVID-19 is crucial to determine its most suitable role based on local circumstances.

METHOD

Online databases, specialist websites and social media platforms were searched to identify studies that explore the utility of LUS in COVID-19. Case reports and recommendations were excluded.

FINDINGS

In total, 33 studies were identified which represent a rapidly expanding evidence base for LUS in COVID-19. The quality of the included studies was relatively low; however, LUS certainly appears to be a highly sensitive and fairly specific test for COVID-19 in all ages and in pregnancy.

DISCUSSION

There may be LUS findings and patterns that are relatively specific to COVID-19; however, specificity may also be influenced by factors such as disease severity, pre-existing lung disease, operator experience, disease prevalence and the reference standard.

CONCLUSION

LUS is almost certainly more sensitive than chest radiograph for COVID-19 and has several advantages over computed tomography and real-time polymerase chain reaction. High-quality research is needed into various aspects of LUS including: diagnostic accuracy in undifferentiated patients; triage and prognostication; monitoring progression and guiding interventions; the persistence of residual LUS findings; inter-observer agreement and the role of contrast-enhanced LUS.

摘要

引言

肺部超声(LUS)已有充分的证据基础,并且在以往的病毒流行中已证明是有用的。了解LUS在2019冠状病毒病(COVID-19)中的效用对于根据当地情况确定其最合适的作用至关重要。

方法

检索在线数据库、专业网站和社交媒体平台,以识别探索LUS在COVID-19中效用的研究。排除病例报告和建议。

结果

共识别出33项研究,这些研究代表了LUS在COVID-19中迅速扩大的证据基础。纳入研究的质量相对较低;然而,LUS在所有年龄段和妊娠期对COVID-19似乎确实是一种高度敏感且相当特异的检测方法。

讨论

可能存在相对特定于COVID-19的LUS表现和模式;然而,特异性也可能受到疾病严重程度、既往肺部疾病、操作者经验、疾病患病率和参考标准等因素的影响。

结论

LUS对COVID-19的敏感性几乎肯定高于胸部X光片,并且相对于计算机断层扫描和实时聚合酶链反应具有多个优势。需要对LUS的各个方面进行高质量的研究,包括:未分化患者的诊断准确性;分诊和预后评估;监测病情进展和指导干预;LUS残留表现的持续时间;观察者间的一致性以及对比增强LUS的作用。

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