Comparative study of lung ultrasound and chest computed tomography scan in the assessment of severity of confirmed COVID-19 pneumonia
2020
Zieleskiewicz, Laurent | Markarian, Thibaut | Lopez, Alexandre | Taguet, Chloé | Mohammedi, Neyla | Boucekine, Mohamed | Baumstarck, Karine | Besch, Guillaume | Mathon, Gautier | Duclos, Gary | Bouvet, Lionel | Michelet, Pierre | Allaouchiche, Bernard | Chaumoître, Kathia | Di Bisceglie, Mathieu | Leone, Marc | Service Anesthésie et Réanimation [Hôpital Nord - APHM] ; Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Nord [CHU - APHM] | Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN) ; Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) | Assistance Publique - Hôpitaux de Marseille (APHM) | Aix-Marseille Université - École de médecine (AMU SMPM MED) ; Aix-Marseille Université - Faculté des sciences médicales et paramédicales (AMU SMPM) ; Aix Marseille Université (AMU)-Aix Marseille Université (AMU) | Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS) ; Aix Marseille Université (AMU) | Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon) | Hospices Civils de Lyon (HCL) | CIC CHU Lyon (inserm) ; Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM) | Microbes Evolution Phylogénie et Infections (MEPHI) ; Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)
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Show more [+] Less [-]English. Purpose The relationship between lung ultrasound (LUS) and chest computed tomography (CT) scans in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia is not clearly defined. The primary objective of our study was to assess the performance of LUS in determining severity of SARS-CoV-2 pneumonia compared with chest CT scan. Secondary objectives were to test the association between LUS score and location of the patient, use of mechanical ventilation, and the pulse oximetry (SpO(2))/fractional inspired oxygen (FiO(2)) ratio. Methods A multicentre observational study was performed between 15 March and 20 April 2020. Patients in the Emergency Department (ED) or Intensive Care Unit (ICU) with acute dyspnoea who were PCR positive for SARS-CoV-2, and who had LUS and chest CT performed within a 24-h period, were included. Results One hundred patients were included. LUS score was significantly associated with pneumonia severity assessed by chest CT and clinical features. The AUC of the ROC curve of the relationship of LUS versus chest CT for the assessment of severe SARS-CoV-2 pneumonia was 0.78 (CI 95% 0.68-0.87;p < 0.0001). A high LUS score was associated with the use of mechanical ventilation, and with a SpO(2)/FiO(2)ratio below 357. Conclusion In known SARS-CoV-2 pneumonia patients, the LUS score was predictive of pneumonia severity as assessed by a chest CT scan and clinical features. Within the limitations inherent to our study design, LUS can be used to assess SARS-CoV-2 pneumonia severity.
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