Lung ultrasound as a screening tool for SARS‐CoV‐2 infection in surgical patients

• Published in: Journal of clinical ultrasound 2022-11, Vol.50 (9), p.1271-1278
• Main Authors: García, Alberto F., Ángel‐Isaza, Ana María, Chica, Julian, Estrada, David Esteban, Vargas‐Morales, Carlos Andrés, Revelo‐Noguera, Jorge, Morell, Tatiana, Gómez, Jeison Antonio, Rodríguez Holguín, Fernando, Umaña, Mauricio, Serna, José Julián, Carvajal, Sandra
• Format: Article
• Language: English
• Subjects: COVID-19; COVID-19 Testing; COVID‐19‐suspected cases; Humans; Infections; Lung - diagnostic imaging; Lung Ultrasound; Lungs; Male; Middle Aged; Patients; Pleura; Pneumonia; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; surgical patients; Ultrasonic imaging; Ultrasonography - methods; Ultrasound
• ISSN: 0091-2751; 1097-0096
• DOI: 10.1002/jcu.23358

Purpose To evaluate the diagnostic performance of lung ultrasound (LUS) in screening for SARS‐CoV‐2 infection in patients requiring surgery. Methods Patients underwent a LUS protocol that included a scoring system for screening COVID‐19 pneumonia as well as RT‐PCR test for SARS‐CoV‐2. The receiver operator characteristic (ROC) curve was determined for the relationship between LUS score and PCR test results for COVID‐19. The optimal threshold for the best discrimination between non‐COVID‐19 patients and COVID‐19 patients was calculated. Results Among 203 patients enrolled (mean age 48 years; 82 males), 8.3% were COVID‐19‐positive; 4.9% were diagnosed via the initial RT‐PCR test. Of the patients diagnosed with SARS‐CoV‐2, 64.7% required in‐hospital management and 17.6% died. The most common ultrasound findings were B lines (19.7%) and a thickened pleura (19.2%). The AUC of the ROC curve of the relationship of LUS score with a cutoff value >8 versus RT‐PCR test for the assessment of SARS‐CoV‐2 pneumonia was 0.75 (95% CI 0.61–0.89; sensitivity 52.9%; specificity 91%; LR (+) 6.15, LR (−) 0.51). Conclusion The LUS score in surgical patients is not a useful tool for screening patients with potential COVID‐19 infection. LUS score shows a high specificity with a cut‐off value of 8. In a high prevalence setting of SARS‐CoV‐2 infection, lung ultrasound severity score (LUSS) > 8 showed a high specificity. However, it cannot be recommended as a screening tool in patients requiring surgery due to its low sensitivity. B lines and subpleural consolidations had the best performance at identifying patients with pneumonia.