A Comparison of Lung Ultrasound and Computed Tomography in the Diagnosis of Patients with COVID-19: A Systematic Review and Meta-Analysis

Mengshu Wang; Xufei Luo; Ling Wang; Janne Estill; Meng Lv; Ying Zhu; Qi Wang; Xiaojuan Xiao; Yang Song; Myeong Soo Lee; Hyeong Sik Ahn; Junqiang Lei; Jinhui Tian

doi:10.3390/diagnostics11081351

A Comparison of Lung Ultrasound and Computed Tomography in the Diagnosis of Patients with COVID-19: A Systematic Review and Meta-Analysis

Diagnostics (Basel). 2021 Jul 27;11(8):1351. doi: 10.3390/diagnostics11081351.

Authors

Mengshu Wang^{1

2}, Xufei Luo³, Ling Wang⁴, Janne Estill⁵, Meng Lv^{6

7

8}, Ying Zhu¹, Qi Wang^{9

10}, Xiaojuan Xiao¹¹, Yang Song¹², Myeong Soo Lee^{13

14

15}, Hyeong Sik Ahn^{16

17

18

19}, Junqiang Lei^{2

20

21}, Jinhui Tian^{1

22}

Affiliations

¹ Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.
² Department of Radiology, The First Hospital of Lanzhou University, Lanzhou 730000, China.
³ School of Public Health, Lanzhou University, Lanzhou 730000, China.
⁴ Department of Ultrasound, People's Hospital of Gansu Province, Lanzhou 730000, China.
⁵ Institute of Global Health, University of Geneva, 1211 Geneva, Switzerland.
⁶ Department of Nephrology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
⁷ National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China.
⁸ Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
⁹ Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada.
¹⁰ McMaster Health Forum, McMaster University, Hamilton, ON L8S 4L8, Canada.
¹¹ Department of Radiology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, China.
¹² Iberoamerican Cochrane Centre-Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain.
¹³ Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
¹⁴ Korean Convergence Medicine, University of Science and Technology, Daejeon 34113, Korea.
¹⁵ Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
¹⁶ Department of Preventive Medicine, Korea University, Seoul 02841, Korea.
¹⁷ Korea Cochrane Centre, Seoul 02841, Korea.
¹⁸ Institute for Evidence Based Medicine, College of Medicine, Korea University, Seoul 02841, Korea.
¹⁹ Department of Preventive Medicine, College of Medicine, Korea University, Seoul 02841, Korea.
²⁰ Intelligent Imaging Medical Engineering Research Center of Gansu Province, Lanzhou 730000, China.
²¹ Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou 730000, China.
²² Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China.

Abstract

Background Lung ultrasound (LUS) and computed tomography (CT) can both be used for diagnosis of interstitial pneumonia caused by coronavirus disease 2019 (COVID-19), but the agreement between LUS and CT is unknown. Purpose to compare the agreement of LUS and CT in the diagnosis of interstitial pneumonia caused by COVID-19. Materials and Methods We searched PubMed, Cochrane library, Embase, Chinese Biomedicine Literature, and WHO COVID-19 databases to identify studies that compared LUS with CT in the diagnosis of interstitial pneumonia caused by COVID-19. We calculated the pooled overall, positive and negative percent agreements, diagnostic odds ratio (DOR) and the area under the standard receiver operating curve (SROC) for LUS in the diagnosis of COVID-19 compared with CT. Results We identified 1896 records, of which nine studies involving 531 patients were finally included. The pooled overall, positive and negative percentage agreements of LUS for the diagnosis of interstitial pneumonia caused by COVID-19 compared with CT were 81% (95% confidence interval [CI] 43-99%), 96% (95% CI, 80-99%, I² = 92.15%) and 80% (95%CI, 60-92%, I² = 92.85%), respectively. DOR was 37.41 (95% CI, 9.43-148.49, I² = 63.9%), and the area under the SROC curve was 0.94 (95% CI, 0.92-0.96). The quality of evidence for both specificity and sensitivity was low because of heterogeneity and risk of bias. Conclusion The level of diagnostic agreement between LUS and CT in the diagnosis of interstitial pneumonia caused by COVID-19 is high. LUS can be therefore considered as an equally accurate alternative for CT in situations where molecular tests are not available.

Keywords: COVID-19; POCUS; computed tomography; lung ultrasound; systematic review.

Publication types

Review