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?:abstract
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OBJECTIVES: To assess the diagnostic yield of point-of-care ultrasound imaging in patients suspected of having noncritical severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection but no apparent changes on a chest radiograph MATERIAL AND METHODS: Cross-sectional analysis of a case series including patients coming to an emergency department in March and April 2020 with mild-moderate respiratory symptoms suspected to be caused by SARS-CoV-2 A point-of-care ultrasound examination of the lungs was performed on all participants as part of routine clinical care Ultrasound findings were compared according to the results of SARS-CoV-2 test results RESULTS: Fifty-eight patients with a median (interquartile range) age of 44 5 (34-67) years were enrolled;42 (72 4%) were women Twenty-seven (46 5%) had confirmed SARS-CoV-2 infection Ultrasound findings were consistent with interstitial pneumonia due to coronavirus disease 2019 (COVID-19) in 33 (56 9%) Most were in cases with testconfirmed COVID-19 (100% vs 22 2% of cases with no confirmation;P < 001) The most common ultrasound findings in confirmed COVID-19 cases were focal and confluent B-lines in the basal and posterior regions of the lung (R1, 85 2%;R2, 77 8%;L1, 88 9%;and L2, 88 9%) and associated pleural involvement (70 4%, 70 4%, 81 5%, and 85 2%, respectively) The sensitivity of point-of-care ultrasound in the diagnosis of COVID-19 was 92 6% (95% CI, 75 7%-99 1%) Specificity was 85 2% (95% CI, 66 3%-95 8%);positive predictive value, 75 8% (95% CI, 59 6%- 91 9%);negative predictive value, 92% (95% CI, 74 0%-99 0%);and positive and negative likelihood ratios, 6 2 (95% CI, 6 0-6 5) and 0 1 (95% CI, 0 1-0 1), respectively CONCLUSION: Point-of-care lung ultrasound could be useful for the diagnosis of noncritical SARS-CoV-2 infection when chest radiographs are inconclusive
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