• Carla Maria Irene Quarato, Antonio Mirijello, Donato Lacedonia, Raffaele Russo, Michele Maria Maggi, Gaetano Rea, Annalisa Simeone, Cristina Borelli, Beatrice Feragalli, Giulia Scioscia, Barbaro Maria Pia Foschino MPF 0000-0001-9939-2697 COVID-19 Center, Policlinico "Riuniti" di Foggia, Department of Medical and Surgical Sciences, Inst, Valentina Massa, Salvatore De Cosmo, and Marco Sperandeo.
• COVID-19 Center, Policlinico "Riuniti" di Foggia, Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, University of Foggia, 71100 Foggia, Italy.
• Medicina (Kaunas). 2021 Mar 4; 57 (3).

AbstractBackground and Objectives: The potential role of lung ultrasound (LUS) in characterizing lung involvement in Coronavirus disease 2019 (COVID-19) is still debated. The aim of the study was to estimate sensitivity of admission LUS for the detection of SARS-CoV-2 lung involvement using Chest-CT (Computed Tomography) as reference standard in order to assess LUS usefulness in ruling out COVID-19 pneumonia in the Emergency Department (ED). Methods: Eighty-two patients with confirmed COVID-19 and signs of lung involvement on Chest-CT were consecutively admitted to our hospital and recruited in the study. Chest-CT and LUS examination were concurrently performed within the first 6-12h from admission. Sensitivity of LUS was calculated using CT findings as a reference standard. Results: Global LUS sensitivity in detecting COVID-19 pulmonary lesions was 52%. LUS sensitivity ranged from 8% in case of focal and sporadic ground-glass opacities (mild disease), to 52% for a crazy-paving pattern (moderate disease) and up to 100% in case of extensive subpleural consolidations (severe disease), although LUS was not always able to detect all the consolidations assessed at Chest-CT. LUS sensitivity was higher in detecting a typical Chest-CT pattern (60%) and abnormalities showing a middle-lower zone predominance (79%). Conclusions: As admission LUS may result falsely negative in most cases, it should not be considered as a reliable imaging tool in ruling out COVID-19 pneumonia in patients presenting in ED. It may at least represent an expanded clinical evaluation that needs integration with other diagnostic tests (e.g., nasopharyngeal swab, Chest-CT).

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