Efficacy of a short course of lung ultrasound for primary care physicians in the assessment of COVID-19-positive patients. (8th January 2022)

• Record Type: Journal Article
• Authors: Raiteri, Alberto; Muratori, Luca; Faggiano, Chiara; Alvisi, Margherita; Serio, Ilaria; Piscaglia, Fabio
• Is Part Of: Family practice. Volume 39:Number 4(2022)
• Page Start: 656
• Page End: 661
• Publication Date: 2022-01-08
• Subjects: COVID-19 -- home care services -- lung ultrasound -- outpatients -- primary care -- SARS-CoV-2; Primary care (Medicine) -- Periodicals; Clinical medicine -- Periodicals; 616.005
• DOI: 10.1093/fampra/cmab150
• Languages: English
• ISSNs: 0263-2136

Abstract

Abstract: Introduction: Lung ultrasound (LUS) has become the first diagnostic imaging approach to assess lung involvement in COVID-19. While LUS proved to be safe, reliable, and accurate, not many primary care physicians (PCP) are capable to employ this instrument in the first evaluation of COVID-19 outpatients. The aim of this study was to determine the effectiveness of a brief training program in LUS for PCP. Methods: Italian local authorities promoted a training program in LUS for PCP engaged in COVID-19 outpatients' evaluation. The course took place in a COVID-19 unit and included a hands-on practice on real COVID-19 patients. We conducted a qualitative and quantitative analysis of the results of the training program. Results: A total of 32 PCP completed the training. About 100% of participants reported an increase in competence and confidence in the use of LUS after the training. Self-reported confidence in detecting major COVID-19 LUS abnormalities was high (B-lines 8/10, pleural abnormalities 6.5/10). B-lines were accurately identified with a reliability of 81%, with a sensitivity of 96%, and a negative predictive value of 98%. Trainees were some less accurate in detecting pleural abnormalities (reliability 63%) but with a high specificity (99%). Conclusions: This study showed that a short training program, but comprising a hands-on practice, is capable to bring even almost novices to achieve a high overall accuracy and reliability in detecting lung involvement in COVID-19. This may result in a significant improvement of the performances of PCP involved in the first evaluation of COVID-19 cases in primary care facilities.