Lung Ultrasound using a Handheld Device to Diagnose COVID-19 in the Emergency Department

Authors

Abdulrahman M. Alfuraih^{1, *,} , Abdussalam A. Alshehri², Hani M. Alshehri², Sami A. Alamri², Tariq S. Aleyyed², Khalid G. Alaufi², Mohammed J. Alsaadi¹

¹Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Kharj, Saudi Arabia

²Emergency Department, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia

^*Corresponding author. Email: a.alfuraih@psau.edu.sa

DOI

10.2991/dsahmj.k.210823.001How to use a DOI?

Keywords

COVID-19; SARS-CoV-2; point-of-care ultrasound; diagnostic test; sensitivity; specificity

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.

Copyright

© 2021 Dr. Sulaiman Al Habib Medical Group. Publishing services by Atlantis Press International B.V.

Open Access

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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TY  - JOUR
AU  - Abdulrahman M. Alfuraih
AU  - Abdussalam A. Alshehri
AU  - Hani M. Alshehri
AU  - Sami A. Alamri
AU  - Tariq S. Aleyyed
AU  - Khalid G. Alaufi
AU  - Mohammed J. Alsaadi
PY  - 2021
DA  - 2021/08/31
TI  - Lung Ultrasound using a Handheld Device to Diagnose COVID-19 in the Emergency Department
JO  - Dr. Sulaiman Al Habib Medical Journal
SP  - 147
EP  - 153
VL  - 3
IS  - 4
SN  - 2590-3349
UR  - https://doi.org/10.2991/dsahmj.k.210823.001
DO  - 10.2991/dsahmj.k.210823.001
ID  - Alfuraih2021
ER  -