Frequency of Abnormalities Detected by Point-of-Care Lung Ultrasound in Symptomatic COVID-19 Patients: Systematic Review and Meta-Analysis

Department

Medicine

Document Type

Article

Publication Title

American Journal of Tropical Medicine and Hygiene

Abstract

The COVID-19 pandemic has resulted in significant morbidity, mortality, and strained healthcare systems worldwide. Thus, a search for modalities that can expedite and improve the diagnosis and management of this entity is underway. Recent data suggested the utility of lung ultrasound (LUS) in the diagnosis of COVID-19 by detecting an interstitial pattern (B-pattern). Hence, we aimed to pool the proportion of various reported lung abnormalities detected by LUS in symptomatic COVID-19 patients. We conducted a systematic review (PubMed, MEDLINE, and EMBASE until April 25, 2020) and a proportion meta-analysis. We included seven studies examining the role of LUS in 122 COVID-19 patients. The pooled proportion (PP) of B-pattern detected by lung ultrasound (US) was 0.97 (95% CI: 0.94-1.00 0%, 4.6). The PP of finding pleural line abnormalities was 0.70 (95% CI: 0.13-1.00 96%, 103.9), of pleural thickening was 0.54 (95% 0.11-0.95 93%, 61.1), of subpleural or pulmonary consolidation was 0.39 (95% CI: 0.21-0.58 72%, 17.8), and of pleural effusion was 0.14 (95% CI: 0.00-0.37 93%, 27.3). Our meta-analysis revealed that almost all SARS-CoV-2-infected patients have abnormal lung US. The most common abnormality is interstitial involvement depicted as B-pattern. The finding from our review highlights the potential role of this modality in the triage, diagnosis, and follow-up of COVID-19 patients. A sizable diagnostic accuracy study comparing LUS, computed tomography scan, and COVID-19-specific tests is warranted to further test this finding and to delineate the diagnostic and prognostic yield of each of these modalities.

First Page

815

Last Page

821

DOI

10.4269/ajtmh.20-0371

Volume

103

Issue

2

Publication Date

8-1-2020

Medical Subject Headings

Betacoronavirus; COVID-19; Coronavirus Infections (diagnostic imaging); Humans; Lung (diagnostic imaging, pathology); Pandemics; Pleural Effusion; Pneumonia, Viral (diagnostic imaging); Point-of-Care Systems; SARS-CoV-2; Ultrasonography

PubMed ID

32500849

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