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
Abstract
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.
Persistent Identifiers
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
Subjects
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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