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Point-of-care lung ultrasonography for early identification of mild COVID-19: a prospective cohort of outpatients in a Swiss screening center.
Schaad, Siméon; Brahier, Thomas; Hartley, Mary-Anne; Cordonnier, Jean-Baptiste; Bosso, Luca; Espejo, Tanguy; Pantet, Olivier; Hugli, Olivier; Carron, Pierre-Nicolas; Meuwly, Jean-Yves; Boillat-Blanco, Noémie.
  • Schaad S; Infectious Diseases Service, University Hospital of Lausanne, Lausanne, Switzerland simeon.schaad@unil.ch.
  • Brahier T; Infectious Diseases Service, University Hospital of Lausanne, Lausanne, Switzerland.
  • Hartley MA; Digital global Health Department, University of Lausanne, Lausanne, Switzerland.
  • Cordonnier JB; Machine Learning and Optimization Laboratory, EPFL, Lausanne, Switzerland.
  • Bosso L; Machine Learning and Optimization Laboratory, EPFL, Lausanne, Switzerland.
  • Espejo T; Emergency Department, Lausanne University Hospital Emergency Care Service, Lausanne, Switzerland.
  • Pantet O; Emergency Department, Lausanne University Hospital Emergency Care Service, Lausanne, Switzerland.
  • Hugli O; Adult Intensive Care Unit, Lausanne University Hospital, Lausanne, Switzerland.
  • Carron PN; Emergency Department, Lausanne University Hospital Emergency Care Service, Lausanne, Switzerland.
  • Meuwly JY; Emergency Department, Lausanne University Hospital Emergency Care Service, Lausanne, Switzerland.
  • Boillat-Blanco N; Department of Radiology, Lausanne University Hospital Division of Radio-diagnostics and Interventional Radiology, Lausanne, Switzerland.
BMJ Open ; 12(6): e060181, 2022 06 24.
Article in English | MEDLINE | ID: covidwho-1909763
ABSTRACT

OBJECTIVES:

Early identification of SARS-CoV-2 infection is important to guide quarantine and reduce transmission. This study evaluates the diagnostic performance of lung ultrasound (LUS), an affordable, consumable-free point-of-care tool, for COVID-19 screening. DESIGN, SETTING AND

PARTICIPANTS:

This prospective observational cohort included adults presenting with cough and/or dyspnoea at a SARS-CoV-2 screening centre of Lausanne University Hospital between 31 March and 8 May 2020.

INTERVENTIONS:

Investigators recorded standardised LUS images and videos in 10 lung zones per patient. Two blinded independent experts reviewed LUS recording and classified abnormal findings according to prespecified criteria to investigate their predictive value to diagnose SARS-CoV-2 infection according to PCR on nasopharyngeal swabs (COVID-19 positive vs COVID-19 negative). PRIMARY AND SECONDARY OUTCOME

MEASURES:

We finally combined LUS and clinical findings to derive a multivariate logistic regression diagnostic score.

RESULTS:

Of 134 included patients, 23% (n=30/134) were COVID-19 positive and 77% (n=103/134) were COVID-19 negative; 85%, (n=114/134) cases were previously healthy healthcare workers presenting within 2-5 days of symptom onset (IQR). Abnormal LUS findings were significantly more frequent in COVID-19 positive compared with COVID-19 negative (45% vs 26%, p=0.045) and mostly consisted of focal pathologic B lines. Combining clinical findings in a multivariate logistic regression score had an area under the receiver operating curve of 80.3% to detect COVID-19, and slightly improved to 84.5% with the addition of LUS features.

CONCLUSIONS:

COVID-19-positive patients are significantly more likely to have lung pathology by LUS. However, LUS has an insufficient sensitivity and is not an appropriate screening tool in outpatients. LUS only adds little value to clinical features alone.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Humans Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2021-060181

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Humans Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2021-060181