Handheld Lung Ultrasound to Detect COVID-19 Pneumonia in Inpatients: A Prospective Cohort Study
Background: Chest imaging, including chest X-ray (CXR) and computed tomography (CT), can be a helpful adjunct to nucleic acid test (NAT) in the diagnosis and management of Coronavirus Disease 2019 (COVID-19). Lung point of care ultrasound (POCUS), particularly with handheld devices, is an imaging a...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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CINQUILL Medical Publishers Inc.
2023-11-01
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| Series: | POCUS Journal |
| Subjects: | |
| Online Access: | https://ojs.library.queensu.ca/index.php/pocus/article/view/16484 |
| _version_ | 1797448669480353792 |
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| author | Thomas Heyne Kay Negishi Daniel Choi Ahad Al Saud Lucas Marinacci Patrick Smithedajkul Lily Devaraj Brent Little Dexter Mendoza Efren Flores Milena Petranovic Steven Toal Hamid Shokoohi Andrew Liteplo Benjamin Geisler |
| author_facet | Thomas Heyne Kay Negishi Daniel Choi Ahad Al Saud Lucas Marinacci Patrick Smithedajkul Lily Devaraj Brent Little Dexter Mendoza Efren Flores Milena Petranovic Steven Toal Hamid Shokoohi Andrew Liteplo Benjamin Geisler |
| author_sort | Thomas Heyne |
| collection | DOAJ |
| description |
Background: Chest imaging, including chest X-ray (CXR) and computed tomography (CT), can be a helpful adjunct to nucleic acid test (NAT) in the diagnosis and management of Coronavirus Disease 2019 (COVID-19). Lung point of care ultrasound (POCUS), particularly with handheld devices, is an imaging alternative that is rapid, highly portable, and more accessible in low-resource settings. A standardized POCUS scanning protocol has been proposed to assess the severity of COVID-19 pneumonia, but it has not been sufficiently validated to assess diagnostic accuracy for COVID-19 pneumonia. Purpose: To assess the diagnostic performance of a standardized lung POCUS protocol using a handheld POCUS device to detect patients with either a positive NAT or a COVID-19-typical pattern on CT scan. Methods: Adult inpatients with confirmed or suspected COVID-19 and a recent CT were recruited from April to July 2020. Twelve lung zones were scanned with a handheld POCUS machine. Images were reviewed independently by blinded experts and scored according to the proposed protocol. Patients were divided into low, intermediate, and high suspicion based on their POCUS score. Results: Of 79 subjects, 26.6% had a positive NAT and 31.6% had a typical CT pattern. The receiver operator curve for POCUS had an area under the curve (AUC) of 0.787 for positive NAT and 0.820 for a typical CT. Using a two-point cutoff system, POCUS had a sensitivity of 0.90 and 1.00 compared to NAT and typical CT pattern, respectively, at the lower cutoff; it had a specificity of 0.90 and 0.89 compared to NAT and typical CT pattern at the higher cutoff, respectively. Conclusions: The proposed lung POCUS protocol with a handheld device showed reasonable diagnostic performance to detect inpatients with a positive NAT or typical CT pattern for COVID-19. Particularly in low-resource settings, POCUS with handheld devices may serve as a helpful adjunct for persons under investigation for COVID-19 pneumonia.
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| first_indexed | 2024-03-09T14:14:40Z |
| format | Article |
| id | doaj.art-5b9530a1a758418ca9461c45a8e3aa14 |
| institution | Directory Open Access Journal |
| issn | 2369-8543 |
| language | English |
| last_indexed | 2024-03-09T14:14:40Z |
| publishDate | 2023-11-01 |
| publisher | CINQUILL Medical Publishers Inc. |
| record_format | Article |
| series | POCUS Journal |
| spelling | doaj.art-5b9530a1a758418ca9461c45a8e3aa142023-11-29T05:00:08ZengCINQUILL Medical Publishers Inc.POCUS Journal2369-85432023-11-018210.24908/pocus.v8i2.16484Handheld Lung Ultrasound to Detect COVID-19 Pneumonia in Inpatients: A Prospective Cohort StudyThomas Heyne0https://orcid.org/0000-0003-2109-1995Kay Negishi1Daniel Choi2https://orcid.org/0009-0007-5335-4637Ahad Al Saud3Lucas Marinacci4https://orcid.org/0000-0002-4443-2441Patrick Smithedajkul5Lily Devaraj6Brent LittleDexter Mendoza7https://orcid.org/0000-0001-7571-740XEfren Flores8Milena Petranovic9Steven Toal10Hamid Shokoohi11Andrew Liteplo12https://orcid.org/0000-0002-3439-6651Benjamin Geisler13https://orcid.org/0000-0003-1704-6067Massachusetts General HospitalMassachusetts General HospitalMassachusetts General HospitalMassachusetts General HospitalMassachusetts General HospitalMassachusetts General HospitalMassachusetts General HospitalMassachusetts General HospitalMassachusetts General HospitalMassachusetts General HospitalMassachusetts General HospitalMassachusetts General HospitalMassachusetts General HospitalMassachusetts General Hospital Background: Chest imaging, including chest X-ray (CXR) and computed tomography (CT), can be a helpful adjunct to nucleic acid test (NAT) in the diagnosis and management of Coronavirus Disease 2019 (COVID-19). Lung point of care ultrasound (POCUS), particularly with handheld devices, is an imaging alternative that is rapid, highly portable, and more accessible in low-resource settings. A standardized POCUS scanning protocol has been proposed to assess the severity of COVID-19 pneumonia, but it has not been sufficiently validated to assess diagnostic accuracy for COVID-19 pneumonia. Purpose: To assess the diagnostic performance of a standardized lung POCUS protocol using a handheld POCUS device to detect patients with either a positive NAT or a COVID-19-typical pattern on CT scan. Methods: Adult inpatients with confirmed or suspected COVID-19 and a recent CT were recruited from April to July 2020. Twelve lung zones were scanned with a handheld POCUS machine. Images were reviewed independently by blinded experts and scored according to the proposed protocol. Patients were divided into low, intermediate, and high suspicion based on their POCUS score. Results: Of 79 subjects, 26.6% had a positive NAT and 31.6% had a typical CT pattern. The receiver operator curve for POCUS had an area under the curve (AUC) of 0.787 for positive NAT and 0.820 for a typical CT. Using a two-point cutoff system, POCUS had a sensitivity of 0.90 and 1.00 compared to NAT and typical CT pattern, respectively, at the lower cutoff; it had a specificity of 0.90 and 0.89 compared to NAT and typical CT pattern at the higher cutoff, respectively. Conclusions: The proposed lung POCUS protocol with a handheld device showed reasonable diagnostic performance to detect inpatients with a positive NAT or typical CT pattern for COVID-19. Particularly in low-resource settings, POCUS with handheld devices may serve as a helpful adjunct for persons under investigation for COVID-19 pneumonia. https://ojs.library.queensu.ca/index.php/pocus/article/view/16484Internal MedicinePoint of Care Ultrasound(POCUS)ultra-portablehandheld ultrasoundCOVID-19tomography |
| spellingShingle | Thomas Heyne Kay Negishi Daniel Choi Ahad Al Saud Lucas Marinacci Patrick Smithedajkul Lily Devaraj Brent Little Dexter Mendoza Efren Flores Milena Petranovic Steven Toal Hamid Shokoohi Andrew Liteplo Benjamin Geisler Handheld Lung Ultrasound to Detect COVID-19 Pneumonia in Inpatients: A Prospective Cohort Study POCUS Journal Internal Medicine Point of Care Ultrasound(POCUS) ultra-portable handheld ultrasound COVID-19 tomography |
| title | Handheld Lung Ultrasound to Detect COVID-19 Pneumonia in Inpatients: A Prospective Cohort Study |
| title_full | Handheld Lung Ultrasound to Detect COVID-19 Pneumonia in Inpatients: A Prospective Cohort Study |
| title_fullStr | Handheld Lung Ultrasound to Detect COVID-19 Pneumonia in Inpatients: A Prospective Cohort Study |
| title_full_unstemmed | Handheld Lung Ultrasound to Detect COVID-19 Pneumonia in Inpatients: A Prospective Cohort Study |
| title_short | Handheld Lung Ultrasound to Detect COVID-19 Pneumonia in Inpatients: A Prospective Cohort Study |
| title_sort | handheld lung ultrasound to detect covid 19 pneumonia in inpatients a prospective cohort study |
| topic | Internal Medicine Point of Care Ultrasound(POCUS) ultra-portable handheld ultrasound COVID-19 tomography |
| url | https://ojs.library.queensu.ca/index.php/pocus/article/view/16484 |
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