Point-of-Care Lung Ultrasound Findings in Patients with COVID-19 Pneumonia

Abstract

Patients with novel coronavirus disease typically present with bilateral multilobar ground-glass opacification with a peripheral distribution. The utility of point-of-care ultrasound has been suggested, but detailed descriptions of lung ultrasound findings are not available. We evaluated lung ultrasound findings in 10 patients admitted to the internal medicine ward with COVID-19. All of the patients had characteristic glass rockets with or without the Birolleau variant (white lung). Thick irregular pleural lines and confluent B lines were also present in all of the patients. Five of the 10 patients had small subpleural consolidations. Point-of-care lung ultrasound has multiple advantages, including lack of radiation exposure and repeatability. Also, lung ultrasound has been shown to be more sensitive than a chest radiograph in detecting alveolar-interstitial syndrome. The utilization of lung ultrasound may also reduce exposure of healthcare workers to severe acute respiratory syndrome-coronavirus-2 and may mitigate the shortage of personal protective equipment. Further studies are needed to evaluate the utility of lung ultrasound in the diagnosis and management of COVID-19.

Sensitivity of Lung US compared to Chest CT for the screening of COVID-19: preliminary report of our experience

“…Nevertheless, it should be considered that the speci city and the positive predictive of the same LUS signs may be lowered in a normal setting of non epidemic COVID-19. Indeed, the sonographic ndings described in our case series and in the current available literature on this topic 11,12,13,14,15 shows a considerable overlap with many other lung diseases. An irregular pleural line with increased B-lines may be visible in ARDS, heart failure, nephrotic syndrome, bacterial pneumonia, other viral pneumonia, also minimal pleural effusion, hydropneumothorax, brosis, pulmonary contusion, exacerbations of chronic obstructive pulmonary diseases and neoplastic lymphangitis 16 .…”

“…Frequently reported LUS ndings are the appearance of multiple, con uent or not, B-lines, a thickened and irregular pleural line and small super cial or large areas of consolidation 11,12,13 . Also minimal or rarely larger pleural space uid effusions has been evidenced 14,15 .…”

Changes in lung ultrasound of symptomatic healthcare professionals with COVID‐19 pneumonia and their association with clinical findings

“…LUS has several advantages, including the lack of radiation exposure, the possibility of multiple repetitions, the reduction of exposure of healthcare professionals to SARS-CoV-2 and the mitigation of the shortage of personal protective equipment. 6 Furthermore, LUS also shows prognostic abilities in acute respiratory distress syndrome (ARDS) before hypoxemia becomes evident. 5 In fact, in the T A B L E 1 Distribution of the number of affected areas, consolidation, and other findings of lung ultrasound in the sample evaluated In the present study, we observed that half of the patients had unilateral lung damage, unlike a systematic review of thoracic CT scans in patients with COVID-19 who observed bilateral lung involvement in 87% of cases and multilobar involvement in 78.8% of cases.…”

“…The ultrasound exams were performed in six areas of each hemithorax (two anterior, two lateral and two posterior) while the patients were seated. 6 The transducer was covered with a probe cover, and the ultrasound device was cleaned with disinfectant wipes after each use. LUS images were examined for the following signs: B-lines >2, coalescent B-lines, consolidations, pleural effusion and pleural thickening.…”

“…However, the benefits of these different methods need to be balanced with the available resources, the level of technical knowledge of the personnel, the unique logistic configurations, the risk of infection of the involved operators, and the decontamination of the equipment used. 5,6 LUS has considerably evolved in recent years in terms of its theoretical and operational aspects, and as a consequence, its clinical application has become increasingly widespread. One of the main characteristics of LUS is the ability to define changes that affect the tissue-air ratio on the lung surface.…”