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 < 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.
【저자키워드】 COVID-19, General practice, Lung Ultrasonography, thoracic radiography, 【초록키워드】 primary care, Pneumonia, COVID-19 pandemic, diagnostic, Diagnosis, lung, Interstitial lung disease, Local, Symptom, RT-PCR, sensitivity, specificity, Positive predictive value, Accuracy, Fever, Patient, Spain, Retrospective analysis, chest X-ray, reverse transcription, disease, Admission, patients, reference standard, Healthcare system, Confirmed COVID-19 infection, positive, MOST, interstitial, polymerase chain, evaluate, pathologic, were used, significantly higher, presenting, Fisher test, patients with COVID-19, strained, symptomatic patient, 【제목키워드】 X-ray, Ultrasound,