Pulmonary Ultrasound in the Diagnosis and Monitoring of Coronavirus Disease (COVID-19): A Systematic Review

Abstract

Systemize the evidence of pulmonary ultrasound (PU) use in diagnosis, monitorization or hospital discharge criteria for patients with COVID-19. Systematic review of evidence which utilized PU for diagnosis, monitorization, or as hospital discharge criteria for COVID-19 patients confirmed by RT-PCR between December 1st of 2019 and July 5th of 2020 compared with thoracic radiograph (TR), thoracic tomography (CT) and RT-PCR. Type of study, motives for PU, population, type of transducer and protocol, results of PU, and quantitative or qualitative correlation with TR and/or CT and/or RT-PCR were evaluated. Were evaluated 28 articles with 418 patients. Average age 50 years (SD 25.1 years), 395 adults and 23 children. 143 were women, 13 pregnant women. The most frequent result was diffuse, coalescent and confluent B-lines. The plural line was irregular, interrupted, or thickened. The presence of subpleural consolidation was noduliform, lobar, or multilobar. There was good qualitative correlation between TR and CT and a quantitative correlation with CT of r=0.65 (p<0.001). 44 patients were evaluated only with PU. PU is a useful tool for diagnosis, monitorization, and criteria for hospital discharge for patients with COVID-19.

Ultrasound findings of lung ultrasonography in COVID-19: A systematic review

“…In particular, its use to study pulmonary involvement in COVID-19 has increasingly risen. Recently, other systematic reviews have been published in an attempt to synthesise the available information and establish stronger evidence in this field [79] , [80] , [81] , [82] . However, these studies have only partially described lung ultrasound findings, focusing on the most common findings without exploring the frequency of occurrence of other phenomena.…”

Lung ultrasound findings following COVID-19 hospitalization: A prospective longitudinal cohort study

“…Lung ultrasound (LUS) is a useful tool in the acute care setting to detect and grade the severity of lung involvement in patients with COVID-19 as LUS is a portable, rapid, non-invasive examination that can be performed at the bedside. The typical findings on LUS frequently detected in patients with COVID-19 pneumonia include pleural line irregularities, multiple and at times confluent B-lines and consolidations [ [1] , [2] , [3] , [4] , [5] ]. The LUS findings observed in patients with COVID-19 correlate well with findings on chest computed tomography (CT) [ 1 , 6 , 7 ].…”

“…The typical findings on LUS frequently detected in patients with COVID-19 pneumonia include pleural line irregularities, multiple and at times confluent B-lines and consolidations [ [1] , [2] , [3] , [4] , [5] ]. The LUS findings observed in patients with COVID-19 correlate well with findings on chest computed tomography (CT) [ 1 , 6 , 7 ]. LUS has higher sensitivity than chest X-ray for the diagnosis of COVID-19 pneumonia [ 8 , 9 ] and provides prognostic information regarding adverse outcomes in some studies [ [10] , [11] , [12] , [13] ], although there are heterogenous results regarding the prognostic utility of LUS in the inpatient setting [ 14 , 15 ].…”

“…Several studies have also assessed the dynamic changes in LUS findings during a COVID-19 infection and found that LUS can be used to monitor disease progression during hospitalization [ 1 , 19 , 20 ]. However, whether the LUS findings detected during the initial COVID-19 infection resolve or persist after hospital discharge is less well investigated.…”

COVID-19 in Children: Update on Diagnosis and Management

“…LUS can be an important diagnostic support for imaging in children because of its safety, sensitivity, and ease of use. 50 In particular, it is useful for early detection of interstitial lung diseases with a peripheral distribution. On the other hand, the peripheral localization of pulmonary involvement in COVID-19 permits LUS to be particularly useful for its ability to detect pulmonary pathology abutting the pleura.…”