Comparative study of lung ultrasound and chest computed tomography scan in the assessment of severity of confirmed COVID-19 pneumonia
Comparative study of lung ultrasound and chest computed tomography scan in the assessment of severity of confirmed COVID-19 pneumonia
复制标题
DOI：
10.1007/s00134-020-06186-0
复制
发表时间：
2020-07-29
影响因子：
38.9
通讯作者：
Leone, Marc
中科院分区：
文献类型：
--
作者：
Zieleskiewicz, Laurent;Markarian, Thibaut;Leone, Marc
目的严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）肺炎患者肺部超声（LUS）和胸部CT（CT）之间的关系尚不明确。我们研究的主要目的是评估LUS与胸部CT扫描相比在确定SARS-CoV-2肺炎严重程度方面的性能。次要目的是检验LUS评分与患者位置、机械通气使用和脉搏血氧饱和度（SpO（2））/吸入氧分数（FiO（2））比值之间的相关性。方法在2020年3月15日至4月20日期间进行了一项多中心观察性研究。纳入了在急诊科（艾德）或重症监护室（ICU）接受SARS-CoV-2 PCR阳性且在24小时内进行了LUS和胸部CT的急性呼吸困难患者。结果纳入100例患者。LUS评分与胸部CT和临床特征评估的肺炎严重程度显著相关。LUS与胸部CT评估严重SARS-CoV-2肺炎关系的ROC曲线的AUC为0.78（CI 95% 0.68-0.87;p < 0.0001）。高LUS评分与机械通气的使用相关，SpO（2）/FiO（2）比值低于357。结论在已知的SARS-CoV-2肺炎患者中，LUS评分可预测胸部CT扫描和临床特征评估的肺炎严重程度。在我们的研究设计固有的局限性内，LUS可用于评估SARS-CoV-2肺炎的严重程度。
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.