RT Journal Article
T1 Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study.
A1 Volpicelli, Giovanni
A1 Gargani, Luna
A1 Perlini, Stefano
A1 Spinelli, Stefano
A1 Barbieri, Greta
A1 Lanotte, Antonella
A1 Casasola, Gonzalo García
A1 Nogué-Bou, Ramon
A1 Lamorte, Alessandro
A1 Agricola, Eustachio
A1 Villén, Tomas
A1 Deol, Paramjeet Singh
A1 Nazerian, Peiman
A1 Corradi, Francesco
A1 Stefanone, Valerio
A1 Fraga, Denise Nicole
A1 Navalesi, Paolo
A1 Ferre, Robinson
A1 Boero, Enrico
A1 Martinelli, Giampaolo
A1 Cristoni, Lorenzo
A1 Perani, Cristiano
A1 Vetrugno, Luigi
A1 McDermott, Cian
A1 Miralles-Aguiar, Francisco
A1 Secco, Gianmarco
A1 Zattera, Caterina
A1 Salinaro, Francesco
A1 Grignaschi, Alice
A1 Boccatonda, Andrea
A1 Giostra, Fabrizio
A1 Infante, Marta Nogué
A1 Covella, Michele
A1 Ingallina, Giacomo
A1 Burkert, Julia
A1 Frumento, Paolo
A1 Forfori, Francesco
A1 Ghiadoni, Lorenzo
A1 on behalf of the International Multicenter Study Group on LUS in COVID-19, 
K1 COVID-19
K1 Interstitial pneumonia
K1 Lung ultrasound
K1 SARS-CoV-2
AB 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.
YR 2021
FD 2021-03-20
LK http://hdl.handle.net/10668/17373
UL http://hdl.handle.net/10668/17373
LA en
DS RISalud
RD Apr 7, 2025