Applicability of lung ultrasound in COVID-19 diagnosis and evaluation of the disease progression: A systematic review

Peixoto, Andressa Oliveira; Costa, Raffaele; Uzun, RaÍsa Sanches; Fraga, Andrea M.A.; Ribeiro, José Dirceu; Marson, Fernando Augusto Lima

doi:10.1016/j.pulmoe.2021.02.004

Cited by 58 publications

(48 citation statements)

References 93 publications

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Section: Introductionmentioning

confidence: 99%

“…Computed tomography (CT) of the chest has been widely used to determine the extent of the damage caused by SARS-CoV-2, although it is costly, has low availability, and exposes the patient to ionizing radiation, which limits its use in some populations [ 5 ]. In this scenario, lung ultrasound (LUS) in the evaluation of patients with COVID-19 has been increasingly used and should be encouraged because it is a practical, low-cost, and radiation-free method, in addition to requiring equipment that is easy to clean [ 5 – 7 ]. With the increase in the number of studies, LUS has been shown to be a useful tool to monitor lung disease progression in patients with COVID-19, especially considering that SARS-CoV-2 preferentially affects peripheral areas of the lungs where visualization of LUS signs is quite satisfactory [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Small airway dysfunction on impulse oscillometry and pathological signs on lung ultrasound are frequent in post-COVID-19 patients with persistent respiratory symptoms

et al. 2021

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Background Thousands of people worldwide are suffering the consequences of coronavirus disease-2019 (COVID-19), and impulse oscillometry (IOS) and lung ultrasound (LUS) might be important tools for the follow-up of this population. Our objective was to prospectively evaluate abnormalities detected using these two methods in a cohort of COVID-19 survivors with respiratory symptoms. Methods In this follow-up study, 59 patients underwent clinical evaluations, spirometry, IOS and LUS in the 2nd (M1) and 5th (M2) months after diagnostic confirmation of COVID-19 by real-time reverse transcriptase–polymerase chain reaction. Aeration scores were obtained from the LUS exams based on the following findings: B-lines >2, coalescent B-lines, and subpleural consolidations. Results Fifty-nine (100%) participants had cough and/or dyspnea at M1, which decreased to 38 (64.4%) at M2 (p = 0.0001). Spirometry was abnormal in 26 (44.1%) and 20 (33.9%) participants at M1 and M2, respectively, although without statistical significance (p = 0.10). Normal examination, restrictive patterns, and obstructive patterns were observed in 33 (55.9%), 18 (30.5%), and 8 (13.6%) participants, respectively, at M1 and in 39 (66.1%), 13 (22%), and 7 (11.9%) participants at M2 (p = 0.14). Regarding IOS, considering changes in resistive and reactive parameters, abnormal exams were detected in 52 (88.1%) and 42 (71.2%) participants at M1 and M2, respectively (p = 0.002). Heterogeneity of resistance between 4 and 20 Hz >20% was observed in 38 (64.4%) and 33 (55.9%) participants at M1 and M2, respectively (p = 0.30). Abnormal LUS was observed in 46 (78%) and 36 (61%) participants at M1 and M2, respectively (p = 0.002), with a reduction in aeration scores between M1 and M2 [5 (2–8) vs. 3 (0–6) points, p<0.0001]. Conclusions IOS and LUS abnormalities are frequent in the first 5 months post-COVID-19 infection; however, when prospectively evaluated, significant improvement is evident in the parameters measured by these two methods.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Small airway dysfunction on impulse oscillometry and pathological signs on lung ultrasound are frequent in post-COVID-19 patients with persistent respiratory symptoms

et al. 2021

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“…LUS allows clinicians to detect interstitial pneumonia and to quantify its severity in the Emergency Department (ED). The predominant pattern is of varying degrees of interstitial syndrome and alveolar consolidations, which can be seen as the presence of focal, multifocal and/or confluent B-lines and of pleural irregularities [3,4]. A scoring system that classifies each pathological area in the lung based on the number of sonographic artifacts (e.g., 0 is a normal lung, 3 is the pneumonia pattern) is used to quantify the severity of the pulmonary impairment detected by LUS [3,5,6].…”

Section: Introductionmentioning

confidence: 99%

Diaphragmatic Point-of-Care Ultrasound in COVID-19 Patients in the Emergency Department—A Proof-of-Concept Study

Pivetta

Cara

Paglietta

et al. 2021

JCM

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Background: Lung Ultrasound Evaluation (LUS) is usefully applied in the Emergency Department (ED) to patients with suspected or confirmed COVID-19. Diaphragmatic Ultrasound (DUS) may provide additional insight into ventilatory function. This proof-of-concept study aimed to evaluate the feasibility of LUS and DUS in a third level ED during the COVID-19 pandemic. Methods: Adult patients presenting with COVID-19 symptoms were eligible. After the physical examination, both LUS and DUS (i.e., diaphragmatic motion and thickness) were performed. All patients were followed after 30 days to determine their need for ventilation, admission, and/or a new ED evaluation after discharge. The diagnostic accuracies of diaphragm measurements in assessing the risk of the 30-day outcome were calculated as well as the measurements’ usefulness. Bland–Altman plots were used for comparing bedside and off-line diaphragm measurements. Results: 118 patients were enrolled. Median thickness and motion were 1.7 mm (iqr 0.4) and 1.8 cm (iqr 0.7), respectively, with a mean difference of 0.009 mm (95% CI −0.037–0.056 mm) and −0.051 cm (95% CI −0.108–0.006 cm), respectively. The 30-day outcome was associated with an increase in thickness (OR 5.84, 95% CI 0.96–35.4), and a lower motion (OR 0.49, 95% CI 0.2–1.21). Conclusion: DUS seemed to be feasible and reliable in the ED in a population of patients presenting with symptoms related to COVID-19 infection.

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“…In the ED, lung US can be employed for an early detection of pulmonary involvement in symptomatic patients suspected for COVID-19, with still pending real-time Reverse Transcription Polymerase Chain Reaction (rRT–PCR), as soon as they arrive [ 31 ]. It can also be used in several moments of the natural history of the SARS-CoV-2 (colonization/infection) as it can identify the pulmonary involvement and seriousness of the disease in patients with suspected or confirmed COVID-19 [ 32 ]. It rapidly identifies pulmonary involvement and provides risk stratification, including a prediction of the need for mechanical ventilation and mortality [ 33 ].…”

Section: The Role Of Lung Ultrasound In Covid-19 Diseasementioning

confidence: 99%

Management of COVID-19 Patients in the Emergency Department

Pantazopoulos

Tsikrika

Kolokytha

et al. 2021

JPM

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COVID-19 is an emerging disease of global public health concern. As the pandemic overwhelmed emergency departments (EDs), a restructuring of emergency care delivery became necessary in many hospitals. Furthermore, with more than 2000 papers being published each week, keeping up with ever-changing information has proven to be difficult for emergency physicians. The aim of the present review is to provide emergency physician with a summary of the current literature regarding the management of COVID-19 patients in the emergency department.

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Applicability of lung ultrasound in COVID-19 diagnosis and evaluation of the disease progression: A systematic review

Cited by 58 publications

References 93 publications

Small airway dysfunction on impulse oscillometry and pathological signs on lung ultrasound are frequent in post-COVID-19 patients with persistent respiratory symptoms

Small airway dysfunction on impulse oscillometry and pathological signs on lung ultrasound are frequent in post-COVID-19 patients with persistent respiratory symptoms

Diaphragmatic Point-of-Care Ultrasound in COVID-19 Patients in the Emergency Department—A Proof-of-Concept Study

Management of COVID-19 Patients in the Emergency Department

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