FEATURES OF THE USE OF ULTRASOUND EXAMINATION IN THE DIAGNOSIS OF COMMUNITY-ACQUIRED PNEUMONIA BEFORE AND DURING THE COVID-19 PANDEMIC
DOI:
https://doi.org/10.32782/pub.health.2023.3.4Keywords:
Lung ultrasound (LUS), community-acquired pneumonia (CAP), COVID-19Abstract
Relevance. Early and accurate diagnosis of community-acquired pneumonia (CAP) is crucial for effective treatment and prevention of complications. The traditional method of diagnosing CAP is chest radiography (CXR). However, chest X-rays have limitations such as low sensitivity in detecting small or peripheral infiltrates and exposure to ionising radiation. In contrast, lung ultrasound can detect small and peripheral lung lesions with higher sensitivity than CXR and is a quick and safe method. The purpose of this study is to determine the value, reliability and importance of lung ultrasound for the diagnosis of CAP. Materials and methods. The method of ultrasonography, systematic and analytical method of analysis (for the study of scientific, methodological and analytical documents, namely: articles, research and meta-analyses), as well as statistical, descriptive, graphical methods and the method of mathematical analysis, were used. Results. The sensitivity of ultrasound in the diagnosis of community-acquired pneumonia (before the COVID-19 pandemic) ranged from 83% to 95%, which is a very good indicator. Average sensitivity of ultrasound for the diagnosis of pneumonia: 90.67%. The average specificity of ultrasound for the diagnosis of CAP is 91.33%. Pooled data from meta-analyses during the COVID-19 pandemic showed that ultrasound has a high sensitivity of 90% and a moderately low specificity of 70.6% for the diagnosis of COVID-19 pneumonia compared to CT chest. Thus, ultrasound has a high sensitivity for true positives (90%) and a low false-negative rate compared to CT. When performing ultrasound examinations during an outpatient visit, we found that 55.4% of patients had pleuropulmonary changes, including 32% of patients with ultrasound signs of viral pneumonia with varying degrees of severity. No pathology was detected in 41.2% of patients. Conclusions. Ultrasound examination provides a good result in achieving diagnostic, prognostic and therapeutic goals. Ultrasound is an excellent tool at the point of care and can help in early diagnosis, therapeutic decision-making and follow-up monitoring of pneumonia, especially in intensive care and in pregnant women, children and patients in areas with high rates of infection transmission. Ultrasonography of the lungs can reduce the use of radiological diagnostic imaging. Ultrasonography can determine the extent of lung involvement in CAP (including SARS-CoV-2-associated CAP) and allow for timely treatment.
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