Skip to main content

Main menu

  • Home
  • Current issue
  • Early View
  • Archive
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • COVID-19 submission information
    • Institutional open access agreements
    • Peer reviewer login
  • Alerts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us
  • My Cart

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • Early View
  • Archive
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • COVID-19 submission information
    • Institutional open access agreements
    • Peer reviewer login
  • Alerts
  • Subscriptions

Diagnosing COVID-19 pneumonia in a pandemic setting: Lung Ultrasound versus CT (LUVCT) A multi-centre, prospective, observational study

A.W.E. Lieveld, B. Kok, F.H. Schuit, K. Azijli, J. Heijmans, A. van Laarhoven, N.L. Assman, R.S. Kootte, T.J. Olgers, P.W.B. Nanayakkara, F.H. Bosch
ERJ Open Research 2020; DOI: 10.1183/23120541.00539-2020
A.W.E. Lieveld
1Section General and Acute Internal Medicine, Department of Internal Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
6These authors contributed equally
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for A.W.E. Lieveld
B. Kok
2Section Acute Medicine, Department of Internal Medicine, Radboudumc, Nijmegen, The Netherlands
6These authors contributed equally
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
F.H. Schuit
1Section General and Acute Internal Medicine, Department of Internal Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
6These authors contributed equally
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
K. Azijli
3Section Emergency Medicine, Emergency department, Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
J. Heijmans
4Section Acute Medicine, Department of Internal Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
A. van Laarhoven
2Section Acute Medicine, Department of Internal Medicine, Radboudumc, Nijmegen, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
N.L. Assman
2Section Acute Medicine, Department of Internal Medicine, Radboudumc, Nijmegen, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
R.S. Kootte
4Section Acute Medicine, Department of Internal Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
T.J. Olgers
5Section Acute Medicine, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
P.W.B. Nanayakkara
1Section General and Acute Internal Medicine, Department of Internal Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for P.W.B. Nanayakkara
  • For correspondence: p.nanayakkara@amsterdamumc.nl
F.H. Bosch
2Section Acute Medicine, Department of Internal Medicine, Radboudumc, Nijmegen, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • PDF
Loading

Abstract

Background In this COVID-19 pandemic, fast and accurate testing is needed to profile patients at the emergency department (ED) and efficiently allocate resources. Chest imaging has been considered in COVID-19 workup, but evidence on lung ultrasound (LUS) is sparse. We therefore aimed to assess and compare the diagnostic accuracy of LUS and computed tomography (CT) in suspected COVID-19 patients.

Methods This multi-centre, prospective, observational study included adult patients with suspected COVID-19 referred to internal medicine at the ED. We calculated diagnostic accuracy measures for LUS and CT using both PCR and multi-disciplinary team (MDT) diagnosis as reference. We also assessed agreement between LUS and CT, and between sonographers.

Results Between March 19 and May 4, 2020, 187 patients were included. Area under the receiver operating characteristic (AUROC) was 0.81 (CI 0.75–0.88) for LUS and 0.89 (CI 0.84–0.94) for CT. Sensitivity and specificity for LUS were 91.9% (CI 84.0–96.7) and 71.0% (CI 61.1–79.6), versus 88.4% (CI 79.7–94.3) and 82.0% (CI 73.1–89.0) for CT. Negative likelihood ratio was 0.1 (CI 0.06–0.24) for LUS and 0.14 (0.08–0.3) for CT. No patient with a false negative LUS, required supplemental oxygen or admission. LUS specificity increased to 80% (CI 69.9–87.9) compared to MDT diagnosis, with an AUROC of 0.85 (CI 0.79–0.91). Agreement between LUS and CT was 0.65. Inter-observer agreement for LUS was good: 0.89 (CI 0.83–0.93).

Conclusion LUS and CT have comparable diagnostic accuracy for COVID-19 pneumonia. LUS can safely exclude clinically relevant COVID-19 pneumonia and may aid COVID-19 diagnosis in high prevalence situations.

Footnotes

This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Lieveld has nothing to disclose.

Conflict of interest: Dr. Kok has nothing to disclose.

Conflict of interest: Dr. Schuit has nothing to disclose.

Conflict of interest: Dr. Azijli has nothing to disclose.

Conflict of interest: Dr. Heijmans has nothing to disclose.

Conflict of interest: Dr. van Laarhoven has nothing to disclose.

Conflict of interest: Dr. Assman has nothing to disclose.

Conflict of interest: Dr. Kootte has nothing to disclose.

Conflict of interest: Dr. Olgers has nothing to disclose.

Conflict of interest: Dr. Nanayakkara has nothing to disclose.

Conflict of interest: Dr. Bosch has nothing to disclose.

This is a PDF-only article. Please click on the PDF link above to read it.

  • Received July 30, 2020.
  • Accepted September 30, 2020.
  • Copyright ©ERS 2020
http://creativecommons.org/licenses/by-nc/4.0/

This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

Next
Back to top
Vol 8 Issue 3 Table of Contents
ERJ Open Research: 8 (3)
  • Table of Contents
  • Index by author
Email

Thank you for your interest in spreading the word on European Respiratory Society .

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Diagnosing COVID-19 pneumonia in a pandemic setting: Lung Ultrasound versus CT (LUVCT) A multi-centre, prospective, observational study
(Your Name) has sent you a message from European Respiratory Society
(Your Name) thought you would like to see the European Respiratory Society web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Print
Citation Tools
Diagnosing COVID-19 pneumonia in a pandemic setting: Lung Ultrasound versus CT (LUVCT) A multi-centre, prospective, observational study
A.W.E. Lieveld, B. Kok, F.H. Schuit, K. Azijli, J. Heijmans, A. van Laarhoven, N.L. Assman, R.S. Kootte, T.J. Olgers, P.W.B. Nanayakkara, F.H. Bosch
ERJ Open Research Jan 2020, 00539-2020; DOI: 10.1183/23120541.00539-2020

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Diagnosing COVID-19 pneumonia in a pandemic setting: Lung Ultrasound versus CT (LUVCT) A multi-centre, prospective, observational study
A.W.E. Lieveld, B. Kok, F.H. Schuit, K. Azijli, J. Heijmans, A. van Laarhoven, N.L. Assman, R.S. Kootte, T.J. Olgers, P.W.B. Nanayakkara, F.H. Bosch
ERJ Open Research Jan 2020, 00539-2020; DOI: 10.1183/23120541.00539-2020
del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
Full Text (PDF)

Jump To

  • Article
    • Abstract
  • Info & Metrics
  • PDF

Subjects

  • Respiratory infections and tuberculosis
  • Lung imaging
  • Tweet Widget
  • Facebook Like
  • Google Plus One

More in this TOC Section

  • Microbial and host immune factors as drivers of COPD
  • Asymmetry in acute exacerbation of IPF
  • Multiple large clusters of tuberculosis in London
Show more Original article

Related Articles

Navigate

  • Home
  • Current issue
  • Archive

About ERJ Open Research

  • Editorial board
  • Journal information
  • Press
  • Permissions and reprints
  • Advertising

The European Respiratory Society

  • Society home
  • myERS
  • Privacy policy
  • Accessibility

ERS publications

  • European Respiratory Journal
  • ERJ Open Research
  • European Respiratory Review
  • Breathe
  • ERS books online
  • ERS Bookshop

Help

  • Feedback

For authors

  • Instructions for authors
  • Publication ethics and malpractice
  • Submit a manuscript

For readers

  • Alerts
  • Subjects
  • RSS

Subscriptions

  • Accessing the ERS publications

Contact us

European Respiratory Society
442 Glossop Road
Sheffield S10 2PX
United Kingdom
Tel: +44 114 2672860
Email: journals@ersnet.org

ISSN

Online ISSN: 2312-0541

Copyright © 2022 by the European Respiratory Society