Skip to content
Volpicelli G, Gargani L, Perlini S, Spinelli S, Barbieri G, Lanotte A, Casasola GG, Nogué-Bou R, Lamorte A, Agricola E, Villén T, Deol PS, Nazerian P, Corradi F, Stefanone V, Fraga DN, Navalesi P, Ferre R, Boero E, Martinelli G, Cristoni L, Perani C, Vetrugno L, McDermott C, Miralles-Aguiar F, Secco G, Zattera C, Salinaro F, Grignaschi A, Boccatonda A, Giostra F, Infante MN, Covella M, Ingallina G, Burkert J, Frumento P, Forfori F, Ghiadoni L; on behalf of the International Multicenter Study Group on LUS in COVID-19. Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study. Intensive Care Med. 2021 Mar 20:1–11. doi: 10.1007/s00134-021-06373-7. Epub ahead of print. PMID: 33743018; PMCID: PMC7980130.

Purpose: To analyze the application of a lung ultrasound (LUS)-based diagnostic approach to patients suspected of COVID-19, combining the LUS likelihood of COVID-19 pneumonia with patient’s symptoms and clinical history.

Methods: This is an international multicenter observational study in 20 US and European hospitals. Patients suspected of COVID-19 were tested with reverse transcription-polymerase chain reaction (RT-PCR) swab test and had an LUS examination. We identified three clinical phenotypes based on pre-existing chronic diseases (mixed phenotype), and on the presence (severe phenotype) or absence (mild phenotype) of signs and/or symptoms of respiratory failure at presentation. We defined the LUS likelihood of COVID-19 pneumonia according to four different patterns: high (HighLUS), intermediate (IntLUS), alternative (AltLUS), and low (LowLUS) probability. The combination of patterns and phenotypes with RT-PCR results was described and analyzed.

Results: We studied 1462 patients, classified in mild (n = 400), severe (n = 727), and mixed (n = 335) phenotypes. HighLUS and IntLUS showed an overall sensitivity of 90.2% (95% CI 88.23-91.97%) in identifying patients with positive RT-PCR, with higher values in the mixed (94.7%) and severe phenotype (97.1%), and even higher in those patients with objective respiratory failure (99.3%). The HighLUS showed a specificity of 88.8% (CI 85.55-91.65%) that was higher in the mild phenotype (94.4%; CI 90.0-97.0%). At multivariate analysis, the HighLUS was a strong independent predictor of RT-PCR positivity (odds ratio 4.2, confidence interval 2.6-6.7, p < 0.0001).

Conclusion: Combining LUS patterns of probability with clinical phenotypes at presentation can rapidly identify those patients with or without COVID-19 pneumonia at bedside. This approach could support and expedite patients’ management during a pandemic surge.

assignment_turned_in Registrations

    
     
   
Please login to view this page.
Please login to view this page.
Please login to view this page.
No item in the cart
Go shopping!