A Modified Corona Score Using Lung Ultrasound to Identify COVID-19 Patients

Area of Science:

• Medical Imaging
• Infectious Disease Diagnostics
• Point-of-Care Ultrasound

Background:

• COVID-19 remains a global health concern with ongoing circulation of various strains.
• Accessible and alternative diagnostic methods are crucial, especially in out-of-hospital settings and low-resource regions.
• Traditional testing methods may have limitations in availability and accessibility.

Purpose of the Study:

• To compare the diagnostic performance of traditional and modified corona score methods for identifying COVID-19.
• To evaluate the utility of lung ultrasound (LUS) and chest X-ray (CXR) in these scoring systems.
• To assess the effectiveness of LUS-based scoring in resource-limited scenarios.

Main Methods:

• Retrospective multicenter study comparing traditional corona score with two modified versions (M1CS including LUS and CXR, M2CS using LUS only).
• Point-of-care lung ultrasound (LUS) and physical examinations were performed by emergency physicians.
• Nasopharyngeal swabs were used for SARS-CoV-2 testing.

Main Results:

• Significant differences were observed in corona scores and modified scores between SARS-CoV-2 positive and negative groups (p < 0.001).
• SARS-CoV-2 positive patients exhibited specific clinical and imaging findings, including fewer pleural irregularities and more interstitial patterns on CXR.
• Modified corona scores, particularly M2CS using LUS alone, demonstrated strong predictive ability.

Conclusions:

• Lung ultrasound (LUS) significantly contributes to and enhances the performance of corona scoring for COVID-19 diagnosis.
• LUS alone, without CXR, offers comparable diagnostic performance, making it suitable for resource-limited settings.
• Ultrasound can serve as a sole imaging modality for diagnosing SARS-CoV-2 pneumonia where CXRs are inaccessible or costly.