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Lung ultrasound as a screening tool for SARS‐CoV‐2 infection in surgical patients
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 o...
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Published in: | Journal of clinical ultrasound 2022-11, Vol.50 (9), p.1271-1278 |
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creator | 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 |
description | 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. |
doi_str_mv | 10.1002/jcu.23358 |
format | article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9874590</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2734486590</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4438-30cc91e36fd9e63f92900945cdfb18790c50baa68bc6fc5e8f2489cee08241e63</originalsourceid><addsrcrecordid>eNp1kc9qVDEUh0OptGPbRV9AAt3o4rb5e2-yEYZBqzJQaB23IZNJxgx3kjG5UbrzEfqMfZJGby0qdJNz4Hz5csIPgFOMzjFC5GJjyjmhlIs9MMFIdg1Cst0Hk1pwQzqOD8HLnDcIoZZzfgAOaUtqT-UELOYlrGHph6RzLGEFdYYaZpOsDb5Ohhh76GKCN9Prm_ufd7P4pZ4E-uCsGXwMtYO5pLU3uoc7PXgbhnwMXjjdZ3vyWI_A4v27z7MPzfzq8uNsOm8MY1Q0FBkjsaWtW0nbUieJrCszblZuiUUnkeFoqXUrlqZ1hlvhCBPSWIsEYbjeOAJvR--uLLd2ZerbSfdql_xWp1sVtVf_ToL_qtbxu5KiY1yiKnj9KEjxW7F5UFufje17HWwsWZGOEIoZxrSiZ_-hm1hSqN-rFGVMtKPwzUiZFHNO1j0tg5H6FZaqYanfYVX21d_bP5F_0qnAxQj88L29fd6kPs0Wo_IB1t6gJA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2734486590</pqid></control><display><type>article</type><title>Lung ultrasound as a screening tool for SARS‐CoV‐2 infection in surgical patients</title><source>Wiley</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description>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.</description><identifier>ISSN: 0091-2751</identifier><identifier>EISSN: 1097-0096</identifier><identifier>DOI: 10.1002/jcu.23358</identifier><identifier>PMID: 36200639</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>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</subject><ispartof>Journal of clinical ultrasound, 2022-11, Vol.50 (9), p.1271-1278</ispartof><rights>2022 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4438-30cc91e36fd9e63f92900945cdfb18790c50baa68bc6fc5e8f2489cee08241e63</citedby><cites>FETCH-LOGICAL-c4438-30cc91e36fd9e63f92900945cdfb18790c50baa68bc6fc5e8f2489cee08241e63</cites><orcidid>0000-0002-6407-1735 ; 0000-0002-5326-2317 ; 0000-0003-4191-8603 ; 0000-0002-4096-1434 ; 0000-0001-9829-8930 ; 0000-0001-6877-6022 ; 0000-0001-7918-6685 ; 0000-0003-3161-2766 ; 0000-0003-1927-2340</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36200639$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>García, Alberto F.</creatorcontrib><creatorcontrib>Ángel‐Isaza, Ana María</creatorcontrib><creatorcontrib>Chica, Julian</creatorcontrib><creatorcontrib>Estrada, David Esteban</creatorcontrib><creatorcontrib>Vargas‐Morales, Carlos Andrés</creatorcontrib><creatorcontrib>Revelo‐Noguera, Jorge</creatorcontrib><creatorcontrib>Morell, Tatiana</creatorcontrib><creatorcontrib>Gómez, Jeison Antonio</creatorcontrib><creatorcontrib>Rodríguez Holguín, Fernando</creatorcontrib><creatorcontrib>Umaña, Mauricio</creatorcontrib><creatorcontrib>Serna, José Julián</creatorcontrib><creatorcontrib>Carvajal, Sandra</creatorcontrib><title>Lung ultrasound as a screening tool for SARS‐CoV‐2 infection in surgical patients</title><title>Journal of clinical ultrasound</title><addtitle>J Clin Ultrasound</addtitle><description>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.</description><subject>COVID-19</subject><subject>COVID-19 Testing</subject><subject>COVID‐19‐suspected cases</subject><subject>Humans</subject><subject>Infections</subject><subject>Lung - diagnostic imaging</subject><subject>Lung Ultrasound</subject><subject>Lungs</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Pleura</subject><subject>Pneumonia</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>surgical patients</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography - methods</subject><subject>Ultrasound</subject><issn>0091-2751</issn><issn>1097-0096</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp1kc9qVDEUh0OptGPbRV9AAt3o4rb5e2-yEYZBqzJQaB23IZNJxgx3kjG5UbrzEfqMfZJGby0qdJNz4Hz5csIPgFOMzjFC5GJjyjmhlIs9MMFIdg1Cst0Hk1pwQzqOD8HLnDcIoZZzfgAOaUtqT-UELOYlrGHph6RzLGEFdYYaZpOsDb5Ohhh76GKCN9Prm_ufd7P4pZ4E-uCsGXwMtYO5pLU3uoc7PXgbhnwMXjjdZ3vyWI_A4v27z7MPzfzq8uNsOm8MY1Q0FBkjsaWtW0nbUieJrCszblZuiUUnkeFoqXUrlqZ1hlvhCBPSWIsEYbjeOAJvR--uLLd2ZerbSfdql_xWp1sVtVf_ToL_qtbxu5KiY1yiKnj9KEjxW7F5UFufje17HWwsWZGOEIoZxrSiZ_-hm1hSqN-rFGVMtKPwzUiZFHNO1j0tg5H6FZaqYanfYVX21d_bP5F_0qnAxQj88L29fd6kPs0Wo_IB1t6gJA</recordid><startdate>202211</startdate><enddate>202211</enddate><creator>García, Alberto F.</creator><creator>Ángel‐Isaza, Ana María</creator><creator>Chica, Julian</creator><creator>Estrada, David Esteban</creator><creator>Vargas‐Morales, Carlos Andrés</creator><creator>Revelo‐Noguera, Jorge</creator><creator>Morell, Tatiana</creator><creator>Gómez, Jeison Antonio</creator><creator>Rodríguez Holguín, Fernando</creator><creator>Umaña, Mauricio</creator><creator>Serna, José Julián</creator><creator>Carvajal, Sandra</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6407-1735</orcidid><orcidid>https://orcid.org/0000-0002-5326-2317</orcidid><orcidid>https://orcid.org/0000-0003-4191-8603</orcidid><orcidid>https://orcid.org/0000-0002-4096-1434</orcidid><orcidid>https://orcid.org/0000-0001-9829-8930</orcidid><orcidid>https://orcid.org/0000-0001-6877-6022</orcidid><orcidid>https://orcid.org/0000-0001-7918-6685</orcidid><orcidid>https://orcid.org/0000-0003-3161-2766</orcidid><orcidid>https://orcid.org/0000-0003-1927-2340</orcidid></search><sort><creationdate>202211</creationdate><title>Lung ultrasound as a screening tool for SARS‐CoV‐2 infection in surgical patients</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4438-30cc91e36fd9e63f92900945cdfb18790c50baa68bc6fc5e8f2489cee08241e63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>COVID-19</topic><topic>COVID-19 Testing</topic><topic>COVID‐19‐suspected cases</topic><topic>Humans</topic><topic>Infections</topic><topic>Lung - diagnostic imaging</topic><topic>Lung Ultrasound</topic><topic>Lungs</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Pleura</topic><topic>Pneumonia</topic><topic>SARS-CoV-2</topic><topic>Severe acute respiratory syndrome</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>surgical patients</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography - methods</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>García, Alberto F.</creatorcontrib><creatorcontrib>Ángel‐Isaza, Ana María</creatorcontrib><creatorcontrib>Chica, Julian</creatorcontrib><creatorcontrib>Estrada, David Esteban</creatorcontrib><creatorcontrib>Vargas‐Morales, Carlos Andrés</creatorcontrib><creatorcontrib>Revelo‐Noguera, Jorge</creatorcontrib><creatorcontrib>Morell, Tatiana</creatorcontrib><creatorcontrib>Gómez, Jeison Antonio</creatorcontrib><creatorcontrib>Rodríguez Holguín, Fernando</creatorcontrib><creatorcontrib>Umaña, Mauricio</creatorcontrib><creatorcontrib>Serna, José Julián</creatorcontrib><creatorcontrib>Carvajal, Sandra</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical ultrasound</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>García, Alberto F.</au><au>Ángel‐Isaza, Ana María</au><au>Chica, Julian</au><au>Estrada, David Esteban</au><au>Vargas‐Morales, Carlos Andrés</au><au>Revelo‐Noguera, Jorge</au><au>Morell, Tatiana</au><au>Gómez, Jeison Antonio</au><au>Rodríguez Holguín, Fernando</au><au>Umaña, Mauricio</au><au>Serna, José Julián</au><au>Carvajal, Sandra</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lung ultrasound as a screening tool for SARS‐CoV‐2 infection in surgical patients</atitle><jtitle>Journal of clinical ultrasound</jtitle><addtitle>J Clin Ultrasound</addtitle><date>2022-11</date><risdate>2022</risdate><volume>50</volume><issue>9</issue><spage>1271</spage><epage>1278</epage><pages>1271-1278</pages><issn>0091-2751</issn><eissn>1097-0096</eissn><abstract>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.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>36200639</pmid><doi>10.1002/jcu.23358</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6407-1735</orcidid><orcidid>https://orcid.org/0000-0002-5326-2317</orcidid><orcidid>https://orcid.org/0000-0003-4191-8603</orcidid><orcidid>https://orcid.org/0000-0002-4096-1434</orcidid><orcidid>https://orcid.org/0000-0001-9829-8930</orcidid><orcidid>https://orcid.org/0000-0001-6877-6022</orcidid><orcidid>https://orcid.org/0000-0001-7918-6685</orcidid><orcidid>https://orcid.org/0000-0003-3161-2766</orcidid><orcidid>https://orcid.org/0000-0003-1927-2340</orcidid><oa>free_for_read</oa></addata></record> |
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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 |
title | Lung ultrasound as a screening tool for SARS‐CoV‐2 infection in surgical patients |
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