Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study.
Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study.
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DOI：
10.1007/s00134-021-06373-7
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发表时间：
2021-04
影响因子：
38.9
通讯作者：
on behalf of the International Multicenter Study Group on LUS in COVID-19
中科院分区：
文献类型：
--
作者：
Volpicelli G;Gargani L;Perlini S;Spinelli S;Barbieri G;Lanotte A;Casasola GG;Nogué-Bou R;Lamorte A;Agricola E;Villén T;Deol PS;Nazerian P;Corradi F;Stefanone V;Fraga DN;Navalesi P;Ferre R;Boero E;Martinelli G;Cristoni L;Perani C;Vetrugno L;McDermott C;Miralles-Aguiar F;Secco G;Zattera C;Salinaro F;Grignaschi A;Boccatonda A;Giostra F;Infante MN;Covella M;Ingallina G;Burkert J;Frumento P;Forfori F;Ghiadoni L;on behalf of the International Multicenter Study Group on LUS in COVID-19
分析基于肺部超声（LUS）的诊断方法在疑似COVID-19患者中的应用，将LUS的COVID-19肺炎可能性与患者的症状和临床病史相结合。这是一项在20家美国和欧洲医院开展的国际多中心观察性研究。对疑似COVID-19患者进行了逆转录-聚合酶链反应（RT-PCR）拭子检测，并进行了LUS检查。我们根据预先存在的慢性疾病（混合表型）以及就诊时呼吸衰竭体征和/或症状的存在（重度表型）或不存在（轻度表型）确定了三种临床表型。我们根据四种不同的模式定义了COVID-19肺炎的LUS可能性：高（HighLUS），中等（IntLUS），替代（AltLUS）和低（LowLUS）概率。结合RT-PCR结果对模式和表型进行描述和分析。我们研究了1462例患者，分为轻度（n = 400），重度（n = 727）和混合（n = 335）表型。HighLUS和IntLUS在识别RT-PCR阳性患者方面的总体敏感性为90.2%（95%CI 88.23-91.97%），混合型（94.7%）和重度表型（97.1%）的敏感性更高，在客观呼吸衰竭患者中的敏感性更高（99.3%）。HighLUS显示特异性为88.8%（CI 85.55-91.65%），在轻度表型中更高（94.4%; CI 90.0-97.0%）。在多变量分析中，HighLUS是RT-PCR阳性的强独立预测因子（比值比4.2，置信区间2.6-6.7，p < 0.0001）。将LUS的概率模式与临床表现型相结合，可以在床边快速识别出那些患有或不患有COVID-19肺炎的患者。这种方法可以在大流行激增期间支持和加快病人的管理。在线版本包含补充材料，可通过10.1007/s 00134 -021-06373-7获得。
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 < 0.0001). 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. The online version contains supplementary material available at 10.1007/s00134-021-06373-7.
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影响因子：
38.9
作者：
Zieleskiewicz, Laurent;Markarian, Thibaut;Leone, Marc
通讯作者：
Leone, Marc
影响因子：
3.1
作者：
Haak, Svenja L.;Renken, Iris J. E.;van der Kolk, Brigitta (Britt) Y. M.
通讯作者：
van der Kolk, Brigitta (Britt) Y. M.
影响因子：
1.9
作者：
Gargani, Luna;Volpicelli, Giovanni
通讯作者：
Volpicelli, Giovanni
影响因子：
3.4
作者：
Volpicelli, Giovanni;Gargani, Luna
通讯作者：
Gargani, Luna
影响因子：
3.7
作者：
Arevalo-Rodriguez I;Buitrago-Garcia D;Simancas-Racines D;Zambrano-Achig P;Del Campo R;Ciapponi A;Sued O;Martinez-García L;Rutjes AW;Low N;Bossuyt PM;Perez-Molina JA;Zamora J
通讯作者：
Zamora J