Higher Accuracy of Lung Ultrasound over Chest X-ray for Early Diagnosis of COVID-19 Pneumonia

Javier Martínez Redondo, Carles Comas Rodríguez, Jesús Pujol Salud, Montserrat Crespo Pons, Cristina García Serrano, Marta Ortega Bravo and Jose María Palacín Peruga
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Javier Martínez Redondo: Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain
Carles Comas Rodríguez: Department of Mathematics, Campus Cappont, University of Lleida, 25001 Lleida, Spain
Jesús Pujol Salud: Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain
Montserrat Crespo Pons: Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain
Cristina García Serrano: Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain
Marta Ortega Bravo: Research Group in Therapies in Primary Care (GRETAPS), 25007 Lleida, Spain
Jose María Palacín Peruga: Onze de Setembre Primary Care Center, Institut Català de la Salut (ICS), Passeig Onze de Setembre, 10, 25005 Lleida, Spain

IJERPH, 2021, vol. 18, issue 7, 1-10

Abstract: Background: The COVID-19 pandemic rapidly strained healthcare systems worldwide. The reference standard for diagnosis is a positive reverse transcription polymerase chain reaction (RT-PCR) test, but results are not immediate and sensibility is variable. Aim: To evaluate the diagnostic accuracy of lung ultrasound compared to chest X-ray for COVID-19 pneumonia. Design and Setting: A retrospective analysis of symptomatic patients admitted into one primary care centre in Spain between March and September 2020. Method: Patients’ chest X-rays and lung ultrasounds were categorized as normal or pathologic. RT-PCR confirmed COVID-19 infection. Pathologic lung ultrasound images were further categorized as showing either local or diffuse interstitial disease. McNemar and Fisher tests were used to compare diagnostic accuracy. Results: Most of the 212 patients presented fever at admission, either as a standalone symptom (37.74% of patients) or together with others (72.17% of patients). The positive predictive value of the lung ultrasound was 90% for the diffuse interstitial pattern and 46.92% for local pattern. The lung ultrasound had a significantly higher sensitivity (82.75%) ( p < 0.001), but lower specificity (71%) than the chest X-ray (54.02% and 86%, respectively) ( p = 0.008) for identifying interstitial lung disease. Moreover, sensitivity of the lung ultrasound for severe interstitial disease was 100%, and was significantly higher than the chest X-ray (58.33%) ( p = 0.002). Conclusion: The lung ultrasound is more accurate than the chest X-ray for identifying patients with COVID-19 pneumonia and it is especially useful for those presenting diffuse interstitial disease.

Keywords: general practice; lung ultrasonography; thoracic radiography; COVID-19 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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