publication . Article . 2021

Higher Accuracy of Lung Ultrasound over Chest X-ray for Early Diagnosis of COVID-19 Pneumonia

Javier Martínez Redondo; Carles Comas Rodríguez; Jesús Pujol Salud; Montserrat Crespo Pons; Cristina García Serrano; Marta Ortega Bravo; Jose María Palacín Peruga;
Open Access English
  • Published: 27 Mar 2021
  • Publisher: MDPI
  • Country: Spain
Background: The COVID-19 pandemic rapidly strained healthcare systems worldwide. The reference standard for diagnosis is a positive reverse transcription polymerase chain reaction (RT-PCR) test, but results are not immediate and sensibility is variable. Aim: To evaluate the diagnostic accuracy of lung ultrasound compared to chest X-ray for COVID-19 pneumonia. Design and Setting: A retrospective analysis of symptomatic patients admitted into one primary care centre in Spain between March and September 2020. Method: Patients’ chest X-rays and lung ultrasounds were categorized as normal or pathologic. RT-PCR confirmed COVID-19 infection. Pathologic lung ultrasound images were further categorized as showing either local or diffuse interstitial disease. McNemar and Fisher tests were used to compare diagnostic accuracy. Results: Most of the 212 patients presented fever at admission, either as a standalone symptom (37.74% of patients) or together with others (72.17% of patients). The positive predictive value of the lung ultrasound was 90% for the diffuse interstitial pattern and 46.92% for local pattern. The lung ultrasound had a significantly higher sensitivity (82.75%) (p &lt
0.001), but lower specificity (71%) than the chest X-ray (54.02% and 86%, respectively) (p = 0.008) for identifying interstitial lung disease. Moreover, sensitivity of the lung ultrasound for severe interstitial disease was 100%, and was significantly higher than the chest X-ray (58.33%) (p = 0.002). Conclusion: The lung ultrasound is more accurate than the chest X-ray for identifying patients with COVID-19 pneumonia and it is especially useful for those presenting diffuse interstitial disease.
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Fields of Science and Technology classification (FOS)
03 medical and health sciences, 0302 clinical medicine, 030212 general & internal medicine, 030218 nuclear medicine & medical imaging
Sustainable Development Goals (SDG)
3. Good health
free text keywords: General practice, Lung ultrasonography, Thoracic radiography, COVID-19, Health, Toxicology and Mutagenesis, Public Health, Environmental and Occupational Health, Article, general practice, lung ultrasonography, thoracic radiography, COVID-19, Retrospective cohort study, Interstitial lung disease, medicine.disease, medicine, Interstitial Disease, Radiology, medicine.medical_specialty, business.industry, business, Lung ultrasound, McNemar's test, Lung, medicine.anatomical_structure, Pneumonia, Coronavirus disease 2019 (COVID-19), lcsh:Medicine, lcsh:R
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