{"doi":"10.5811/westjem.2020.5.47743","title":"Point-of-care Lung Ultrasound Is More Sensitive than Chest Radiograph for Evaluation of COVID-19","abstract":"INTRODUCTION: Current recommendations for diagnostic imaging for moderately to severely ill patients with suspected coronavirus disease 2019 (COVID-19) include chest radiograph (CXR). Our primary objective was to determine whether lung ultrasound (LUS) B-lines, when excluding patients with alternative etiologies for B-lines, are more sensitive for the associated diagnosis of COVID-19 than CXR. METHODS: This was a retrospective cohort study of all patients who presented to a single, academic emergency department in the United States between March 20 and April 6, 2020, and received LUS, CXR, and viral testing for COVID-19 as part of their diagnostic evaluation. The primary objective was to estimate the test characteristics of both LUS B-lines and CXR for the associated diagnosis of COVID-19. Our secondary objective was to evaluate the proportion of patients with COVID-19 that have secondary LUS findings of pleural abnormalities and subpleural consolidations. RESULTS: We identified 43 patients who underwent both LUS and CXR and were tested for COVID-19. Of these, 27/43 (63%) tested positive. LUS was more sensitive (88.9%, 95% confidence interval (CI), 71.1-97.0) for the associated diagnosis of COVID-19 than CXR (51.9%, 95% CI, 34.0-69.3; p = 0.013). LUS and CXR specificity were 56.3% (95% CI, 33.2-76.9) and 75.0% (95% CI, 50.0-90.3), respectively (p = 0.453). Secondary LUS findings of patients with COVID-19 demonstrated 21/27 (77.8%) had pleural abnormalities and 10/27 (37%) had subpleural consolidations. CONCLUSION: Among patients who underwent LUS and CXR, LUS was found to have a higher sensitivity than CXR for the evaluation of COVID-19. This data could have important implications as an aid in the diagnostic evaluation of COVID-19, particularly where viral testing is not available or restricted. If generalizable, future directions would include defining how to incorporate LUS into clinical management and its role in screening lower-risk populations.","journal":"Western Journal of Emergency Medicine","year":2020,"id":57640,"datarank":0.6535063240034389,"base_score":4.356708826689592,"endowment":4.356708826689592,"self_citation_contribution":0.6535063240034389,"citation_network_contribution":0.0,"self_endowment_contribution":0.6535063240034389,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":77,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9186,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":301470,"name":"Ingrid Camelo","orcid":"0000-0002-0883-2499","position":1,"is_corresponding":false},{"id":301471,"name":"Kelly Mayo","orcid":"0000-0003-1228-6571","position":2,"is_corresponding":false},{"id":301472,"name":"Megan Leo","orcid":"0000-0001-5299-2492","position":3,"is_corresponding":false},{"id":301473,"name":"Julianne Dugas","orcid":"0000-0003-1644-0134","position":4,"is_corresponding":false},{"id":301474,"name":"Kerrie P. Nelson","orcid":"0000-0002-1195-8105","position":5,"is_corresponding":false},{"id":301475,"name":"William E. Baker","orcid":"0000-0002-4915-2553","position":6,"is_corresponding":false},{"id":301476,"name":"Faizah Shareef","orcid":"0000-0003-4133-3058","position":7,"is_corresponding":false},{"id":301477,"name":"Patricia Mitchell","orcid":"0000-0002-6159-1778","position":8,"is_corresponding":false},{"id":301478,"name":"Elissa M. Schechter‐Perkins","orcid":"0000-0003-1798-9663","position":9,"is_corresponding":false},{"id":301469,"name":"Joseph R. Pare","orcid":"0000-0001-6156-1379","position":0,"is_corresponding":true}],"reference_count":18,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T21:06:48.611399Z","pmid":"32726240","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}