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. 2023 Dec 26;14(1):51.
doi: 10.3390/diagnostics14010051.

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

Costantino Caroselli  1 , Michael Blaivas  2 , Yale Tung Chen  3 , Matteo Marcosignori  4 , Antonio Cherubini  1 , Daniele Longo  5   6
Affiliations

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

Costantino Caroselli et al. Diagnostics (Basel). .

Abstract

Background: COVID-19 continues to circulate around the world with multiple different strains being active at once. While diagnosis with antigen and molecular testing is more readily available, there is still room for alternative methods of diagnosis, particularly in out-of-hospital settings, e.g., home or nursing homes, and in low-medium income countries, where testing may not be readily available.

Study objectives: To evaluate the performance of two modified corona score methods compared with a traditional corona score approach to identify patients with COVID-19.

Methods: This was a retrospective multicenter study performed to compare the ability to predict SARS-CoV-2 test results on a nasopharyngeal swab between the corona scores and two novel corona scores (modified 1 corona score (M1CS) and modified 2 corona score (M2CS)). The M1CS included lung ultrasound (LUS) and chest X-ray (CXR) results, while the M2SC only utilized LUS findings without CXRs. Emergency physicians performed point-of-care LUS and a physical examination upon admission to the emergency department.

Results: Subjects positive for SARS-CoV-2 were older and had higher ferritin levels and temperature and lower diastolic blood pressure and oxygen saturation. The two groups differed on corona score and modified corona scores (p < 0.001 for all). SARS-CoV-2-positive patients had fewer pleural line irregularities (p = 0.025) but presented more frequently with an interstitial pattern on CXRs (p < 0.001).

Conclusions: In our study, LUS alone provided a valuable contribution to the corona score and improved its performance more than when CXR results were included. These results suggest that resource-limited areas where CXRs may be unavailable or prohibitively expensive can utilize an ultrasound as the sole imaging modality without a loss of diagnostic performance for SARS-CoV-2 pneumonia diagnosis.

Keywords: COVID-19; SARS-CoV-2; corona score; lung ultrasound; point of care.

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Conflict of interest statement

The authors declare that they have no conflicts of interest related to the publication of this manuscript.

Figures

Figure 1
Figure 1
The diagnostic pathways carried out in subjects included in the retrospective study.
Figure 2
Figure 2
A CXR and LUS of the same subject, respectively, with bilateral infiltrates and small consolidation areas.
Figure 3
Figure 3
Sensitivity and specificity of a genuine corona score. The area under the ROC curve was 0.713 (95% CI 0.601–0.822) for the score.
Figure 4
Figure 4
Sensitivity and specificity of the modified 1 corona score (M1CS). The area under the ROC curve was 0.758 (95% CI 0.649–0.858) for the M1CS.
See this image and copyright information in PMC

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