Lung Ultrasound in COVID-19: Clinical Correlates and Comparison with Chest Computed Tomography

Abstract

Lung ultrasound (LUS) and chest computed tomography (chest CT) are largely employed to evaluate coronavirus disease 2019 (COVID-19) pneumonia. We investigated semi-quantitative LUS and CT scoring in hospitalized COVID-19 patients. LUS and chest CT were performed within 24 h upon admission. Both were analyzed according to semi-quantitative scoring systems. Subgroups were identified according to median LUS score. Patients within higher LUS score group were older (79 vs 60 years, p<0.001), had higher C-reactive protein (CRP) (7.2 mg/dl vs 1.3 mg/dl, p<0.001) and chest CT score (10 vs 4, p=0.027) as well as lower PaO2/FiO2 (286 vs 356, p=0.029) as compared to patients within lower scores. We found a significant correlation between scores (r=0.390, p=0.023). Both LUS and CT scores correlated directly with patients age (r=0.586, p<0.001 and r=0.399, p=0.021 respectively) and CRP (r=0.472, p=0.002 and r=0.518, p=0.002 respectively), inversely with PaO2/FiO2 (r=−0.485, p=0.003 and r=−0.440, p=0.017 respectively). LUS score only showed significant correlation with hs-troponin T, NT-pro-BNP, and creatinine (r=0.433, p=0.019; r=0.411, p=0.027, and r=0.497, p=0.001, respectively). Semi-quantitative bedside LUS is related to the severity of COVID-19 pneumonia similarly to chest CT. Correlation of LUS score with markers of cardiac and renal injury suggests that LUS might contribute to a more comprehensive evaluation of this heterogeneous population.

The utility of lung ultrasound in COVID-19 pneumonia in the intensive care unit in real life settings

“…Furthermore, the same dissociation was observed retrospectively in ARDS before the COVID-19 pandemic 27 and not only in the early phase of ARDS, but also in persistent ARDS 28 . The lack of LUS correlation with CRP, a systemic marker of inflammation, contrasts with previous studies where LUS was positively associated with CRP levels 29,30 . However, these studies were performed in patients admitted to the hospital ward, whereas in our study critically ill patients were included upon ICU admission, therefore CRP levels could be affected by prior in-hospital treatments.…”

The value of lung ultrasound in COVID-19 pneumonia, verified by high resolution computed tomography assessed by artificial intelligence

“…Therefore, LUS is considered a very promising alternative to HRCT as it allows to monitor the disease dynamics without exposing patients to excessive ionizing radiation. Several previous reports additionally showed evidence that both LUS score and CT score may be prognostic factors in patients with COVID-19 [15,[27][28][29].…”

Can Lung Ultrasound Be the Ideal Monitoring Tool to Predict the Clinical Outcome of Mechanically Ventilated COVID-19 Patients? An Observational Study

“…The pragmatic reference standard for diagnosing the infection is the nasopharyngeal molecular swab test, while the chest computed tomography (CT) scan is the gold standard for diagnosing COVID-19 pneumonia [ 2 ]. Lung ultrasound (LUS) is a well-established diagnostic tool in acute respiratory failure and acute respiratory distress syndrome (ARDS), suited for COVID-19 clinical management giving results similar or superior to chest CT and superior to traditional chest X-rays [ 3 , 4 ]. LUS is a useful tool: it can be performed at the bedside, is easy-to-learn, is easy-to-use, is radiation-free, gives relevant clinical information, and permits saving precious time [ 5 ].…”