scholarly journals Point of care lung ultrasound in COVID-19: hype or hope?

BJR|Open ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 20200027
Author(s):  
Abdulrahman M. Alfuraih
Keyword(s):  
World Economy ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
False Negative ◽  
Current Evidence ◽  
Rt Pcr ◽  
Limited Evidence ◽  
Lung Abnormalities ◽  
Diagnostic Role ◽  
Life Threatening

The COVID-19 coronavirus pandemic has critically struck the world economy and healthcare systems. The highly contagious virus spreads rapidly and can result in potentially life-threatening acute respiratory distress. The current established test for diagnosing COVID-19 is using the RT-PCR laboratory test. However, the test requires specialized laboratories and testing kits. Recent reports also showed high false-negative rates. Experts recognize the urgent need to develop a rapid point of care diagnostic tests. Ultrasonography is a widely established safe diagnostic imaging test for detecting various lung abnormalities. Recent publications from China and Italy provided limited evidence on its usefulness for diagnosing COVID-19 in emergency departments earlier than RT-PCR. Ultrasound is sensitive to pleural and subpleural abnormalities, which suggests a great potential diagnostic role given the predilection for COVID-19 in peripheral subpleural regions.This paper reviews the current evidence and discusses the problems with specificity and scoring.

scholarly journals Screening, Diagnostic and Prognostic Tests for COVID-19: A Comprehensive Review

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 561
Author(s):  
Mariana Ulinici ◽  
Serghei Covantev ◽  
James Wingfield-Digby ◽  
Apostolos Beloukas ◽  
Alexander G. Mathioudakis ◽  
...  
Keyword(s):  
Point Of Care ◽  
Standard Test ◽  
Current Evidence ◽  
Molecular Testing ◽  
Rt Pcr ◽  
Diagnostic Screening ◽  
Comprehensive Review ◽  
Prognostic Tests ◽  
Polymerase Chain ◽  
Antigen Testing

While molecular testing with real-time polymerase chain reaction (RT-PCR) remains the gold-standard test for COVID-19 diagnosis and screening, more rapid or affordable molecular and antigen testing options have been developed. More affordable, point-of-care antigen testing, despite being less sensitive compared to molecular assays, might be preferable for wider screening initiatives. Simple laboratory, imaging and clinical parameters could facilitate prognostication and triage. This comprehensive review summarises current evidence on the diagnostic, screening and prognostic tests for COVID-19.

scholarly journals Serologic and Molecular Diagnosis of Anaplasma platys and Ehrlichia canis Infection in Dogs in an Endemic Region

Pathogens ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 488
Author(s):  
Bianca Lara ◽  
Anne Conan ◽  
Mary Anna Thrall ◽  
Jennifer K. Ketzis ◽  
Gillian Carmichael Branford ◽  
...  
Keyword(s):  
Early Stage ◽  
Point Of Care ◽  
False Negative ◽  
Ehrlichia Canis ◽  
Test Results ◽  
Anaplasma Platys ◽  
Endemic Region ◽  
Life Threatening ◽  
Improve Patient Management ◽  
Antibody Levels

Anaplasma platys and Ehrlichia canis are obligate intracellular, tick-borne rickettsial pathogens of dogs that may cause life-threatening diseases. In this study, we assessed the usefulness of PCR and a widely used commercial antibody-based point-of-care (POC) test to diagnose A. platys and E. canis infection and updated the prevalence of these pathogens in dogs inhabiting the Caribbean island of Saint Kitts. We detected A. platys in 62/227 (27%), E. canis in 84/227 (37%), and the presence of both in 43/227 (19%) of the dogs using PCR. POC testing was positive for A. platys in 53/187 (28%), E. canis in 112/187 (60%), and for both in 42/187 (22%) of the samples tested. There was only a slight agreement between A. platys PCR and POC test results and a fair agreement for E. canis PCR and POC test results. Our study suggests that PCR testing may be particularly useful in the early stage of infection when antibody levels are low or undetectable, whereas, POC test is useful when false-negative PCR results occur due to low bacteremia. A combination of PCR and POC tests may increase the ability to diagnose A. platys and E. canis infection and consequently will improve patient management.

Utility of lung ultrasound scanning in neonatology

2018 ◽  
Vol 104 (9) ◽  
pp. 909-915 ◽  
Author(s):  
Patricia Lee Woods
Keyword(s):  
Intensive Care ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Current Evidence ◽  
Clinical Question ◽  
Important Research ◽  
Ultrasound Scanning ◽  
Observational Tool ◽  
Research Questions

The utility of point-of-care lung ultrasound in neonatology is rapidly expanding. This review summarises current evidence of a diagnostic, procedural and observational tool valuable in the management of newborns requiring intensive care. Approaching a patient, probe in-hand with focused clinical question is essential, and barriers to implication together with important research questions are explored.

scholarly journals Abnormal Lung Point-of-Care Ultrasound (POCUS) in Suspected Cases of COVID-19 pneumonia with Normal Plain Chest Radiographs – A Case Series

2020 ◽  
Vol 19 (3) ◽  
pp. 162-167
Author(s):  
Daniel Owen Mort ◽  
◽  
Dipraj Limbu ◽  
Joseph Nunan ◽  
Andrew P. Walden ◽  
...  
Keyword(s):  
Lung Ultrasound ◽  
Point Of Care ◽  
Case Series ◽  
Chest Radiographs ◽  
Nasopharyngeal Swab ◽  
Point Of Care Ultrasound ◽  
Testing Strategy ◽  
Plain Chest ◽  
Timely Access ◽  
Diagnostic Role

COVID-19 pneumonia produces a heterogeneous array of clinical, biochemical, and radiological findings. Over the last few months of global hurry to optimize a testing strategy, it has been suggested that bedside point-of-care lung ultrasound may have a diagnostic role. We present 3 patients with RT-PCR nasopharyngeal swab-confirmed COVID-19 pneumonia, who had an admission plain chest film reported to be normal by a consultant radiologist, but with significant sonographic abnormalities on bedside ultrasound performed within 24 hours of the chest radiograph. Lung ultrasound may better correlate with the oxygen requirement and overall condition of the patient than chest radiographs – a pertinent consideration given the imminent advance of the pandemic into resource-poor zones where timely access to roentgenological imaging may be sparse.

scholarly journals LUNG ULTRASOUND IN RULING OUT COVID-19 AMONG HEALTHCARE WORKERS IN TWO ITALIAN EMERGENCY DEPARTMENTS: A MULTICENTER STUDY.

2021 ◽  
Author(s):  
Roberto Copetti ◽  
Giulia Amore ◽  
Caterina Giudice ◽  
Daniele Orso ◽  
Silvia Cola ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Emergency Departments ◽  
Healthcare Workers ◽  
Lung Ultrasound ◽  
False Negative ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Negative Case ◽  
Adjudication Committee

Purpose: The high percentage of asymptomatic patients and the non-high sensitivity of real-time reverse transcription-polymerase chain reaction (RT-PCR) test on nasopharyngeal swab cause some healthcare workers to be infected but asymptomatic and a source of spread of the epidemic. This study aimed to verify if the lung ultrasound (LUS) had enough high negative predictive value to rule out coronavirus disease 2019 (COVID-19) among a population of healthcare workers operating in the Emergency Department. Methods: A multicenter prospective observational study was conducted, enrolling healthcare workers among the staff of two Emergency Departments in Northeast Italy. The definitive diagnosis of COVID-19 was established by an adjudication committee, based on the clinical data and RT-PCR on nasopharyngeal swab result. Results: From March 30, 2020, to April 22, 2020, we enrolled 155 cases. The adjudication committee determined two true positives for COVID-19. Twenty-one healthcare workers presented suggestive symptoms (2 true positives and 19 false positives). The nasopharyngeal swab was positive in one case (1 false-negative case). LUS was suggestive for COVID-19 pneumonia in 4 cases (2 false-positive cases). The diagnostic accuracy of LUS was 98.7% (95% CI 95.4%-99.8%). The sensitivity and the specificity of LUS were 100% (95% CI 15.8% -100%) and 98.7% (95% CI 95.4% - 99.8%), respectively. The negative predictive value was 100% (95% CI 100% -100%). Conclusion: LUS has a good enough negative predictive value for ruling out COVID-19 in a population of healthcare workers exposed to COVID-19.

scholarly journals Evaluation of saliva molecular point of care for detection of SARS-CoV-2 in ambulatory care

2021 ◽  
Author(s):  
Jerome Le Goff ◽  
Solen Kerneis ◽  
Caroline Elie ◽  
Severine Mercier Delarue ◽  
Nabil Gastli ◽  
...  
Keyword(s):  
Point Of Care ◽  
False Negative ◽  
Lamp Assay ◽  
Rapid Identification ◽  
Ambulatory Setting ◽  
Nasopharyngeal Swab ◽  
Lower Sensitivity ◽  
Rt Pcr ◽  
A Prospective Study ◽  
Antigen Testing

Background: The rapid identification of SARS-CoV-2 infected individuals is a cornerstone in strategies for the control of virus spread. The sensitivity of SARS-CoV-2 RNA detection by RT-PCR is similar in saliva and nasopharyngeal swab. Rapid molecular point-of-care tests in saliva could facilitate, broaden and speed up the diagnosis. Objectives and methods: We conducted a prospective study in two community COVID-19 screening centers to evaluate the performances of a CE-marked RT-LAMP assay (EasyCoV) specifically designed for the detection of SARS-CoV-2 RNA from fresh saliva samples, compared to nasopharyngeal RT-PCR as reference test, saliva RT-PCR and nasopharyngeal antigen testing. Results: Overall, 117 of the 1718 participants (7%) were tested positive with nasopharyngeal RT-PCR. Sensitivities of saliva RT-PCR and nasopharyngeal antigen test were 93% (95% Confidence Interval (95%CI): 86-97) and 85% (95%CI: 77-91), respectively. The sensitivity and specificity of the RT-LAMP assay in saliva were 34% (95%CI: 26-44) and 97% (95%CI: 96-98). The performance was similar in symptomatic and asymptomatic participants and whatever the reference standard considered. Ct values of nasopharyngeal RT-PCR were significantly lower in the 40 true positive subjects with saliva RT-LAMP (Ct 25.9) than in the 48 false negative subjects with saliva RT-LAMP (Ct 28.4) (p=0.028). Conclusion: In the ambulatory setting, the detection of SARS-CoV-2 from crude saliva samples with the RT-LAMP assay had a lower sensitivity than nasopharyngeal RT-PCR, saliva RT-PCR and nasopharyngeal antigen testing.

scholarly journals Point of care lung ultrasound is useful when screening for CoVid-19 in Emergency Department patients.

2020 ◽  
Author(s):  
Andrea Hankins ◽  
Heejung Bang ◽  
Paul Walsh
Keyword(s):  
Emergency Department ◽  
Null Hypothesis ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Vital Signs ◽  
P Value ◽  
Inclusion Criteria ◽  
Upper Respiratory Infection ◽  
Life Threatening ◽  
Emergency Department Patients

Background CoVid-19 can be a life-threatening lung disease or a trivial upper respiratory infection depending on whether the alveoli are involved. Emergency department (ED) screening in symptomatic patients with normal vital signs is frequently limited to oro-nasopharyngeal swabs. We tested the null hypothesis that patients being screened for CoVid-19 in the ED with normal vital signs and without hypoxia would have a point-of-care lung ultrasound (LUS) consistent with CoVid-19 less than 2% of the time. Methods Subjects Subjects were identified from ED ultrasound logs. Inclusion criteria Age 14 years or older with symptoms prompting ED screening for CoVid-19. Exclusion criteria Known congestive heart failure or other chronic lung condition likely to cause excessive B lines on LUS. Intervention Structured blinded ultrasound review and chart review Analysis We used an exact hypothesis tests for binomial random variables. We also measured LUS diagnostic performance using computed tomography as the gold standard. Results We reviewed 77 charts; 62 met inclusion criteria. Vital signs were normal in 31 patients; 10 (32%) of these patients had LUS consistent with CoVid-19. We rejected the null hypothesis (p-value for bitest <0.001). The treating physicians' interpretation of their own point of care lung ultrasounds had a sensitivity of 100% (95% CI 75%, 100%) and specificity of 80% (95% CI 68%, 89%). Conclusion LUS has a meaningful detection rate for CoVid-19 in symptomatic emergency department patients with normal vital signs. We recommend at least LUS be used in addition to PCR testing when screening symptomatic ED patients for CoVid-19.

scholarly journals LUNG ULTRASOUND FINDINGS IN MEXICAN PATIENTS WITH SARS COV2 INFECTION

2020 ◽  
Author(s):  
Luis Fernando L Paredes ◽  
Ivan I Ilescas
Keyword(s):  
Lung Ultrasound ◽  
Early Recognition ◽  
Point Of Care ◽  
New Disease ◽  
Rt Pcr ◽  
Resource Limited ◽  
New Variant ◽  
Ultrasound Findings ◽  
Short Time ◽  
B Lines

In late December 2019, a new disease reported at the time by an unknown pathogen was reported, which was later found to be a new variant of coronavirus, now called SARS-CoV2. This new disease had a very rapid global spread, causing multiple deaths in a short time, and which led to putting the entire world on health alert. In patients who have this disease, they present bilateral opacities in frosted multilobar glass with peripheral distribution. Some authors have suggested the use of ultrasound at the point of care for its early recognition. In this study, we evaluated the findings of lung ultrasound in 25 patients admitted to the General Hospital Dr. Enrique Cabrera, Mexico, with a diagnosis confirmed by RT-PCR of SARS CoV2. This small retrospective study suggests that artifacts like glass rockets with or without the Birolleau variant (White lung), confluent B-lines, thick irregular pleural lines, and variable size (subpleural) consolidations are typical findings of lung ultrasound in patients with COVID-19 pneumonia. The presence of these findings is useful when evaluating patients with suspected COVID-19. In resource-limited and austere settings where chest radiography, CT, and RT-PCR are not available or the response time is long, lung ultrasound performed by trained personnel can be an aid in the diagnosis of COVID-19.

scholarly journals Peran pemeriksaan radiologis pada diagnosis Coronavirus disease 2019

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Budi Yanti ◽  
Ulfa Hayatun
Keyword(s):  
Polymerase Chain Reaction ◽  
Ct Scan ◽  
Real Time ◽  
False Negative ◽  
Ground Glass Opacity ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Lung Abnormalities ◽  
Polymerase Chain ◽  
Radiological Examinations

Abstrak. Coronavirus Disease 19 (COVID-19) telah menjadi pandemi di seluruh dunia dengan angka kejadian yang terus meningkat di beberapa negara. Kecepatan dan ketepatan diagnosis diperlukan untuk mencegah perburukan kondisi pasien. Real-Time Transcription Polymerase Chain Reaction (RT-PCR) sampai saat ini masih menjadi baku emas untuk menegakkan diagnosis COVID-19, namun uji diagnostik ini dilaporkan banyak menunjukkan hasil negatif palsu. Pemeriksaan radiologi berupa foto toraks dan CT-Scan dada banyak dilakukan untuk  menunjang diagnosis COVID-19. Gambaran foto toraks yang paling sering ditemukan adalah konsolidasi, ground-glass opacity (GGO), distribusi bilateral, perifer dan di lobus bawah paru-paru, namun pemeriksaan ini dianggap tidak sensitif untuk menemukan kelainan paru pada tahap awal penyakit. Meskipun demikian, foto toraks dapat digunakan untuk memantau perkembangan kelainan paru akibat COVID-19, salah satunya dengan metode Brixia Score. Pada sisi lain,CT-scan dada dinilai lebih sensitif daripada foto toraks serta mampu menunjukkan kelainan paru tahap awal pada pasien dengan hasil RT-PCR yang negatif. Gambaran pada CT-scan dada umumnya menunjukkan GGO, konsolidasi, crazy-paving stone, dan air bronchogram.  CT-scan dapat mengurangi angka negatif palsu pada RT-PCR dan sebagai alat skrining pada pasien yang dicurigai COVID-19 di lokasi epidemis saat hasil RT-PCR tidak tersedia. Penggunaan pemeriksaan radiologi dan RT-PCR dapat menghemat waktu serta membantu diagnosis dan manajemen COVID-19. Kata Kunci: Pencitraan COVID-19, Radiologi SARS-CoV-2Abstract. Coronavirus Disease 19 (COVID-19) has become a worldwide pandemic with an increasing incidence in several countries. Speed and accuracy of diagnosis are needed to prevent worsening of patient's condition. Real-Time Transcription Polymerase Chain Reaction (RT-PCR) is still a gold standard of COVID-19 diagnosis, however, this test shown false negative results in several case. Radiological examinations, chest X-Ray (CXR) and CT scan, are used to support the diagnosis. The most commonly found in CXR are consolidation, ground-glass opacity (GGO), bilateral distribution, peripheral and in the lower lobe, but this examination is insensitive to find lung abnormalities in early stages of disease. However, CXR can be used to monitor the development of lung abnormalities due to COVID-19, such as the Brixia Score method. On the other hand, CT-Scan is more sensitive than CXR and able to show early lung abnormalities in negative RT-PCR results. CT scan show the presence of GGO, consolidation, crazy-paving stone, and air bronchogram. CT-scanning can reduce the false-negative rate on RT-PCR and become a screening tool in suspected COVID-19 patients at epidemic area where RT-PCR is not available. The use of radiological examinations and RT-PCR can save the time and help in the diagnosis and management of COVID-19.Keywords: COVID-19’s Radiology, Imaging of SARS-CoV-2

scholarly journals Diagnostic Utility of Antigen Detection Rapid Diagnostic Tests for Covid- 19: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Mina Ebrahimi ◽  
Narges Nazari Harmooshi ◽  
Fakher Rahim
Keyword(s):  
Diagnostic Tests ◽  
Point Of Care ◽  
Meta Analysis ◽  
False Negative ◽  
Rapid Test ◽  
Rapid Diagnostic Tests ◽  
Lower Sensitivity ◽  
Sample Type ◽  
Rt Pcr ◽  
Asymptomatic Patients

Background: Early detection of coronavirus disease (COVID-19) infection to improve disease management, becomes the greatest challenge. Despite high sensitivity of RT-PCR, not only it was reported that 20-67% of infected patients have false negative results. Rapid diagnostic tests (RDTs) are widely used as a point-of-care test for SARS-CoV-2 detection in both pharyngeal and blood specimens. To be less time-consuming, not seem so costly, and requiring no special training make it more favorable, but the low sensitivity is the main limitation. Several reports indicated rapid test of blood and pharyngeal samples has the same sensitivity as the RT-PCR, but some reports have lower sensitivity especial in asymptomatic patients. Methods: In the present survey, we investigate the eligible studies for sensitivity and specificity of rapid tests and explore the factors that influence the result to help better diagnose COVID-19 infection. 20 studies met the inclusion criteria, which impose 33 different tests. Results: Our findings showed, type of sample, type of assay, time of sampling, and load of virus influence on sensitivity of RDTs. Conclusion: This research extends our knowledge of how to improve the sensitivity of RDTs to better diagnose of infected patients to address the controlling COVID-19 pandemic.

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