Abdulrahman M. Alfuraih, Abdussalam Alshehri, Hani M. Alshehri, Sami A. Alamri, Tariq S. Aleyyed, Khalid Alaufi, Mohammed J. Alsaadi
{"title":"在急诊科使用手持设备进行肺部超声诊断COVID-19","authors":"Abdulrahman M. Alfuraih, Abdussalam Alshehri, Hani M. Alshehri, Sami A. Alamri, Tariq S. Aleyyed, Khalid Alaufi, Mohammed J. Alsaadi","doi":"10.2991/dsahmj.k.210823.001","DOIUrl":null,"url":null,"abstract":"The Coronavirus Disease 2019 (COVID-19) pandemic has critically struck healthcare systems and burdened emergency services. To date, there is no accurate and rapid point-of-care diagnostic test. This study aimed to investigate Lung Ultrasound (LUS) against Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test in suspected COVID-19 patients presenting to the emergency department. In 20 eligible patients (mean age ± standard deviation, 49 ± 15 years), 12 had a positive RT-PCR test and undergone an LUS examination over 12 lung zones using a handheld ultrasound device. Each zone was semiquantitatively scored according to the Lung Ultrasound Scoring System (LUSS) from 0 to 3 based on the severity of findings (pleural line irregularity, B-lines, consolidations) and documented the presence of light beam artifacts. A second blinded reader scored the images to investigate interreader reproducibility. The LUSS score had a modest diagnostic performance at 66.6% [95% Confidence Interval (CI), 34.9–90.0%] sensitivity and 75.0% (95% CI, 34.9–96.8%) specificity. The light beam artifact was more prevalent and sensitive to COVID-19 patients with 81.8% (95% CI, 48.2–97.7%) sensitivity and 75.0% (95% CI, 34.9–96.8%) specificity. LUS had an almost perfect interreader reproducibility for LUSS (Kendall’s W = 0.961; 95% CI, 0.894–0.985) and light beam artifact (Cohen’s κ = 0.890; 95% CI, 0.683–1.00). Overall, LUS using handheld devices can offer a safe, reproducible, rapid, and feasible first-line tool for detecting COVID-19 patients in emergency departments. The light beam artifact was more sensitive and specific to COVID-19 patients and can be useful for effectively triaging suspected cases.","PeriodicalId":52781,"journal":{"name":"Dr Sulaiman Al Habib Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lung Ultrasound using a Handheld Device to Diagnose COVID-19 in the Emergency Department\",\"authors\":\"Abdulrahman M. Alfuraih, Abdussalam Alshehri, Hani M. Alshehri, Sami A. Alamri, Tariq S. Aleyyed, Khalid Alaufi, Mohammed J. Alsaadi\",\"doi\":\"10.2991/dsahmj.k.210823.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"The Coronavirus Disease 2019 (COVID-19) pandemic has critically struck healthcare systems and burdened emergency services. To date, there is no accurate and rapid point-of-care diagnostic test. This study aimed to investigate Lung Ultrasound (LUS) against Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test in suspected COVID-19 patients presenting to the emergency department. In 20 eligible patients (mean age ± standard deviation, 49 ± 15 years), 12 had a positive RT-PCR test and undergone an LUS examination over 12 lung zones using a handheld ultrasound device. Each zone was semiquantitatively scored according to the Lung Ultrasound Scoring System (LUSS) from 0 to 3 based on the severity of findings (pleural line irregularity, B-lines, consolidations) and documented the presence of light beam artifacts. A second blinded reader scored the images to investigate interreader reproducibility. The LUSS score had a modest diagnostic performance at 66.6% [95% Confidence Interval (CI), 34.9–90.0%] sensitivity and 75.0% (95% CI, 34.9–96.8%) specificity. The light beam artifact was more prevalent and sensitive to COVID-19 patients with 81.8% (95% CI, 48.2–97.7%) sensitivity and 75.0% (95% CI, 34.9–96.8%) specificity. LUS had an almost perfect interreader reproducibility for LUSS (Kendall’s W = 0.961; 95% CI, 0.894–0.985) and light beam artifact (Cohen’s κ = 0.890; 95% CI, 0.683–1.00). Overall, LUS using handheld devices can offer a safe, reproducible, rapid, and feasible first-line tool for detecting COVID-19 patients in emergency departments. The light beam artifact was more sensitive and specific to COVID-19 patients and can be useful for effectively triaging suspected cases.\",\"PeriodicalId\":52781,\"journal\":{\"name\":\"Dr Sulaiman Al Habib Medical Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-08-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Dr Sulaiman Al Habib Medical Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2991/dsahmj.k.210823.001\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Dr Sulaiman Al Habib Medical Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2991/dsahmj.k.210823.001","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Lung Ultrasound using a Handheld Device to Diagnose COVID-19 in the Emergency Department
The Coronavirus Disease 2019 (COVID-19) pandemic has critically struck healthcare systems and burdened emergency services. To date, there is no accurate and rapid point-of-care diagnostic test. This study aimed to investigate Lung Ultrasound (LUS) against Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test in suspected COVID-19 patients presenting to the emergency department. In 20 eligible patients (mean age ± standard deviation, 49 ± 15 years), 12 had a positive RT-PCR test and undergone an LUS examination over 12 lung zones using a handheld ultrasound device. Each zone was semiquantitatively scored according to the Lung Ultrasound Scoring System (LUSS) from 0 to 3 based on the severity of findings (pleural line irregularity, B-lines, consolidations) and documented the presence of light beam artifacts. A second blinded reader scored the images to investigate interreader reproducibility. The LUSS score had a modest diagnostic performance at 66.6% [95% Confidence Interval (CI), 34.9–90.0%] sensitivity and 75.0% (95% CI, 34.9–96.8%) specificity. The light beam artifact was more prevalent and sensitive to COVID-19 patients with 81.8% (95% CI, 48.2–97.7%) sensitivity and 75.0% (95% CI, 34.9–96.8%) specificity. LUS had an almost perfect interreader reproducibility for LUSS (Kendall’s W = 0.961; 95% CI, 0.894–0.985) and light beam artifact (Cohen’s κ = 0.890; 95% CI, 0.683–1.00). Overall, LUS using handheld devices can offer a safe, reproducible, rapid, and feasible first-line tool for detecting COVID-19 patients in emergency departments. The light beam artifact was more sensitive and specific to COVID-19 patients and can be useful for effectively triaging suspected cases.