Challenges and Opportunities for Lung Ultrasound in Novel Coronavirus Disease (COVID-19)
Marcus J. Schultz, Chaisith Sivakorn, Arjen M. Dondorp
Abstract
Novel coronavirus disease (COVID-19) is responsible for hundreds of thousands of hospitalizations worldwide, and this number is still increasing rapidly in many countries as of mid-April 2020. Diagnostic and clinical approaches differ between countries and even within countries because of inconsistent presence of testing materials and variable access to chest imaging. Severe acute respiratory syndrome-coronavirus-2 reverse transcriptase-polymerase chain reaction from nasopharyngeal or throat swabs has a high specificity but moderate sensitivity. Although patients with COVID-19 can present with a normal chest X-ray early in the disease, 1 abnormalities on chest images have a higher sensitivity to detect the disease than molecular testing, but lack specificity. 2 Typical findings on a chest X-ray include bilateral and multi-lobar infiltrates that can progress rapidly over the first days of illness. Chest X-ray is the most commonly used imaging technique in suspected COVID-19 in resource-limited settings. However, the image quality is often poor, and follow-up chest X-rays are difficult in settings with constraints on infrastructure, human resources, and personal protective equipment.