%0 Journal Article
%A Volpicelli, Giovanni
%A Gargani, Luna
%A Perlini, Stefano
%A Spinelli, Stefano
%A Barbieri, Greta
%A Lanotte, Antonella
%A Casasola, Gonzalo García
%A Nogué-Bou, Ramon
%A Lamorte, Alessandro
%A Agricola, Eustachio
%A Villén, Tomas
%A Deol, Paramjeet Singh
%A Nazerian, Peiman
%A Corradi, Francesco
%A Stefanone, Valerio
%A Fraga, Denise Nicole
%A Navalesi, Paolo
%A Ferre, Robinson
%A Boero, Enrico
%A Martinelli, Giampaolo
%A Cristoni, Lorenzo
%A Perani, Cristiano
%A Vetrugno, Luigi
%A McDermott, Cian
%A Miralles-Aguiar, Francisco
%A Secco, Gianmarco
%A Zattera, Caterina
%A Salinaro, Francesco
%A Grignaschi, Alice
%A Boccatonda, Andrea
%A Giostra, Fabrizio
%A Infante, Marta Nogué
%A Covella, Michele
%A Ingallina, Giacomo
%A Burkert, Julia
%A Frumento, Paolo
%A Forfori, Francesco
%A Ghiadoni, Lorenzo
%A on behalf of the International Multicenter Study Group on LUS in COVID-19
%T Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study.
%D 2021
%U http://hdl.handle.net/10668/17373
%X To analyze the application of a lung ultrasound (LUS)-based diagnostic approach to patients suspected of COVID-19, combining the LUS likelihood of COVID-19 pneumonia with patient's symptoms and clinical history. This is an international multicenter observational study in 20 US and European hospitals. Patients suspected of COVID-19 were tested with reverse transcription-polymerase chain reaction (RT-PCR) swab test and had an LUS examination. We identified three clinical phenotypes based on pre-existing chronic diseases (mixed phenotype), and on the presence (severe phenotype) or absence (mild phenotype) of signs and/or symptoms of respiratory failure at presentation. We defined the LUS likelihood of COVID-19 pneumonia according to four different patterns: high (HighLUS), intermediate (IntLUS), alternative (AltLUS), and low (LowLUS) probability. The combination of patterns and phenotypes with RT-PCR results was described and analyzed. We studied 1462 patients, classified in mild (n = 400), severe (n = 727), and mixed (n = 335) phenotypes. HighLUS and IntLUS showed an overall sensitivity of 90.2% (95% CI 88.23-91.97%) in identifying patients with positive RT-PCR, with higher values in the mixed (94.7%) and severe phenotype (97.1%), and even higher in those patients with objective respiratory failure (99.3%). The HighLUS showed a specificity of 88.8% (CI 85.55-91.65%) that was higher in the mild phenotype (94.4%; CI 90.0-97.0%). At multivariate analysis, the HighLUS was a strong independent predictor of RT-PCR positivity (odds ratio 4.2, confidence interval 2.6-6.7, p  Combining LUS patterns of probability with clinical phenotypes at presentation can rapidly identify those patients with or without COVID-19 pneumonia at bedside. This approach could support and expedite patients' management during a pandemic surge.
%K COVID-19
%K Interstitial pneumonia
%K Lung ultrasound
%K SARS-CoV-2
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