Role of lung ultrasonography in the diagnosis of COVID-19 patients admitted to the emergency department
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İshak Şan1 · Burak Bekgöz2 · Eren Usul3 · Çağdaş Yıldırım4 · Emin Gemcioğlu5 · Ahmet Fatih Kahraman4 · Ahmet Emre Ay4 1
Faculty of Medicine, Department of Emergency Medicine, University of Health Sciences, Ankara, Turkey Department of Emergency Medicine, Ankara City Hospital, Ankara, Turkey 3 Emergency Service, Sincan State Hospital, Ankara, Turkey 4 Faculty of Medicine, Department of Emergency Medicine, Yıldırım Beyazıt University, Ankara, Turkey 5 Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey 2
© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2020
Role of lung ultrasonography in the diagnosis of COVID-19 patients admitted to the emergency department Electronic supplementary material The online version of this article (https://doi. org/10.1007/s10049-020-00807-3) shows RT-PCR results of patients with a definitive diagnosis of COVID-19 by lung computed tomography and patients with pneumonia detected by lung ultrasonography. The article and additional material are available at www.springermedizin.de. Please enter the title of the article in the search field. You will find the additional material under “Ergänzende Inhalte” in the article.
Introduction Coronavirus Disease (COVID-19), which first presented as viral pneumonia cases of unknown etiology in Wuhan, China, at the end of 2019, has become a pandemic that has affected the whole world over a short period of time [1, 2]. The World Health Organization (WHO) agreed that the outbreak met the criteria for a Public Health Emergency of International Concern on January 30, 2020 [3]. On February 11, 2020, the WHO named the disease COVID-19, which is short for “coronavirus disease 2019” [4]. Patients may have no-specific symptoms such as fever, fatigue, cough (with or without sputum production), sore throat, and nasal congestion. Rarely,
patients may also present with diarrhea, nausea, and vomiting [5]. Although most patients experience mild disease, 14% of patients have lung involvement [6]. Lung imaging is therefore recommended for COVID-19 patients. The diagnostic value of chest radiography in the early stages is low in some lung disease [7]. However, lung computed tomography (LCT) can show lung involvement even before symptoms begin [8]. Although LCT represents the gold standard for the examination of most pulmonary diseases, it presents some important challenges, such as the high dose of radiation administered to the patient, its nonadministration to some groups of patients (e.g., pregnant women), the need to transport the patient to the radiology department, and the lack of CT scanning in some emergency departments (EDs) [7]. The American College of Radiology (ACR) recommends that CT not be used to screen for, or as a first-line test to diagnose, COVID19. The ACR also recommends that CT be used sparingly and be reserved for hospitalized, symptomatic patients with specific clinical indications for CT [9]. Ultrasonography (US), which is a practical and nonhazardous diagnostic tool, has recently been recognized as offering an efficient way
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