Low Sensitivity of Admission Lung US Compared to Chest CT for Diagnosis of Lung Involvement in a Cohort of 82 Patients with COVID-19 Pneumonia
Carla Maria Irene Quarato,
Antonio Mirijello,
Donato Lacedonia,
Raffaele Russo,
Michele Maria Maggi,
Gaetano Rea,
Annalisa Simeone,
Cristina Borelli,
Beatrice Feragalli,
Giulia Scioscia,
Maria Pia Foschino Barbaro,
Valentina Massa,
Salvatore De Cosmo,
Marco Sperandeo
Affiliations
Carla Maria Irene Quarato
COVID-19 Center, Policlinico “Riuniti” di Foggia, Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, University of Foggia, 71100 Foggia, Italy
Antonio Mirijello
COVID-19 Unit, Department of Medical Sciences, IRCCS Fondazione Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
Donato Lacedonia
COVID-19 Center, Policlinico “Riuniti” di Foggia, Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, University of Foggia, 71100 Foggia, Italy
Raffaele Russo
COVID-19 Center, Intensive Care Unit, Department of Emergency Medicine and Critical Care, IRCCS Fondazione Casa Sollievo Della Sofferenza, 71013 San Giovanni Rotondo, Italy
Michele Maria Maggi
COVID-19 Center, Emergency Medicine Unit, Department of Emergency Medicine and Critical Care, IRCCS Fondazione Casa Sollievo Della Sofferenza, 71013 San Giovanni Rotondo, Italy
Gaetano Rea
Department of Radiology, “Vincenzo Monaldi” Hospital—AORN Ospedale Dei Colli, 80100 Naples, Italy
Annalisa Simeone
Department of Radiology, IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
Cristina Borelli
Department of Radiology, IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
Beatrice Feragalli
Oral and Biotechnological Sciences—Radiology Unit “G. D’Annunzio”, Department of Medical, University of Chieti-Pescara, 66100 Chieti, Italy
Giulia Scioscia
COVID-19 Center, Policlinico “Riuniti” di Foggia, Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, University of Foggia, 71100 Foggia, Italy
Maria Pia Foschino Barbaro
COVID-19 Center, Policlinico “Riuniti” di Foggia, Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, University of Foggia, 71100 Foggia, Italy
Valentina Massa
Geriatric and COVID-19 Unit, Department of Medical Sciences, IRCCS Fondazione Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
Salvatore De Cosmo
COVID-19 Unit, Department of Medical Sciences, IRCCS Fondazione Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
Marco Sperandeo
Unit of Interventional and Diagnostic Ultrasound of Internal Medicine, Department of Medical Sciences, IRCCS Fondazione Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
Background and Objectives: 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). Methods: 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. Results: 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%). Conclusions: 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).
