Abstract
Purpose: The portability of a hand-held ultrasound allows the health care worker to conduct lung ultrasound in out-of-hospital setting. It is used as a tool to conduct staging and triaging for COVID-19 patients. This study evaluated the utilization of lung ultrasound in an out-of-hospital setting versus chest x-rays in detecting and staging of COVID-19 patients with pneumonia.
Methods: The study was conducted among COVID-19 subjects at an out-of-hospital setting whereby lung ultrasound was done and subsequently chest x-rays were taken after being admitted to the health care facilities. Lung ultrasound findings were reviewed by emergency physicians, while the chest x-rays were reviewed by radiologists. Radiologists were blinded by the patients’ lung ultrasound findings and clinical conditions. The analysis of the agreement between the lung ultrasound findings and chest x-rays was conducted.
Results: A total of 261 subjects were recruited. LUS detected pulmonary infiltrative changes in more stage 3 COVID-19 subjects in comparison to chest x-rays. Multiple B-lines were the predominant findings at the right lower anterior, posterior and lateral zones. Interstitial consolidations and ground glass opacities were the predominant descriptive findings in chest x-rays. However, there was no agreement between lung ultrasound and chest x-ray findings in detecting COVID-19 pneumonia as the Cohen’s Kappa coefficient was 0.08 (95% CI 0.06-0.22, p = 0.16).
Conclusion: The diagnostic imaging and staging of COVID-19 patients using lung ultrasound in out-of-hospital settings showed LUS detected lung pleural disease more often than CXR for stage 3 COVID-19 patients.
Keywords: COVID-19; COVID-19 staging; Chest X-rays; Lung ultrasound; Out-of-hospital; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2., Lung ultrasound, chest X-rays, COVID-19 staging, Out-of-hospital, 【초록키워드】 SARS-CoV-2, COVID-19 pneumonia, Health care, Pneumonia, diagnostic, lung, Health, Diagnostic imaging, Chest, ground glass opacities, Physicians, chest X-ray, chest X-rays, utilization, disease, Care, consolidation, COVID-19 patients, Analysis, COVID-19 patient, CXR, Radiologists, Ground glass opacity, staging, 95% CI, subject, clinical conditions, Kappa coefficient, Multiple, Triaging, radiologist, Pleural disease, recruited, the patient, evaluated, conducted, changes in, predominant, was done, infiltrative, were blinded, 【제목키워드】 Ultrasonography, setting,