Severity Determination of Lung Pathological Changes Caused by Covid-19 Using Ultrasound

Abstract

Purpose. To assess the possibilities of ultrasound examination of the lungs in the diagnosis of COVID-19 pathological changes. Materials and methods. 65 patients (50 women and 15 men) with suspected novel coronavirus infection (COVID-19), underwent ultrasound and MSCT of the lungs with an interval of no more than 24 hours, were included at the study. The patients were divided into two groups: the 1st group included 48 patients at the stage of the onset and progression of pneumonia, the 2nd group - 17 patients with signs of recovery - normalization of oxygen saturation on spontaneous breathing, decrease in body temperature (below 37.5 °С). Results. Changes in the lungs detected by ultrasound and MSCT were compared, and the correlation of these changes with lung function, assessed by blood saturation, the need for oxygen insufflation, non-invasive and mechanical ventilation, was studied. In patients without signs of recovery, ultrasound severity corresponded to the severity of MSCT. In patients with signs of recovery, the US-severity is less than the MSCT severity by at least 25% in most cases. When comparing patients with signs of recovery and those at the onset of the disease, significant differences in ultrasound severity were revealed (1.17 versus 2.1, respectively, p = 0.01). It is important that the differences in MSCT severity in these groups are not significant. A correlation was found between the degree of respiratory failure and ultrasound severity both in the general group of patients and in subgroups. The higher the degree of respiratory failure, the greater the US-severity, P = 0.00001. Conclusion. Ultrasound of the lungs allows one to suspect COVID-19 pneumonia, which is especially important during a pandemic. In patients at the onset and peak of pneumonia, the ultrasound severity of the disease, assessed by the area of the lesion, corresponds to the severity of MSCT. In patients with signs of recovery, ultrasound severity is significantly less than the severity of MSCT and is more strongly correlated with impaired lung function