The role of lung ultrasonography in COVID‐19 disease management

Boero, Enrico; Schreiber, Annia; Rovida, Serena; Vetrugno, Luigi; Blaivas, Michael

doi:10.1002/emp2.12194

Cited by 18 publications

(24 citation statements)

References 34 publications

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“…More recently [June 2020], Boero et al [31] evaluated the role of LUS in COVID-19 management and concluded that, a growing evidence supports the use of LUS in COVID-19. However, no data of multicenter studies are available.…”

Section: Disucssionmentioning

confidence: 99%

Ultrasound in Suspected Pneumonic COVID-19: Our Experience

Alrifai

El-Raey

Yousef

et al. 2020

International Journal of Medical Arts

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Background: Coronavirus disease-19 [COVID-19] is a pandemic spreading all over the world. The novel corona virus has a specific tropism for the low respiratory airways causing viral pneumonia. Early diagnosis of suspicious COVID-19 pneumonia represents a pillar for immediate management. Computed tomography [CT] scan is considered the gold-standard screening tool, but it has several limitations. A chest ultrasound could play a role in COVID-19. Aim of the work: To evaluate the role of lung ultrasound [LUS] in diagnosis of suspicious COVID-19 pneumonia. Patients and Methods: Sixty patients with suspected COVID-19 pneumonia were included. They were initially evaluated in triage and initial diagnosis [Al-Azhar University Hospital; Damietta] and followed up by the surveillance and infection control team till the final diagnosis or discharge from isolation hospitals. All were evaluated clinically, by imaging modalities [LUS, chest computed tomography [CT]] and diagnosis confirmed by polymerase chain reaction. Data of LUS and chest CT compared to results of PCR. Results: LUS had sensitivity of 88.2%, specificity of 11.5%, PPV of 56.6%, NPV of 42.8% and overall diagnostic accuracy of 55.0%. on the other side, CT scan had 94.1%, 3.85, 56.14%, 33.33% and 57.0% for sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy, successively. Results of LUS are slightly lower than CT. Conclusion: US is a useful screening and monitoring tool in suspected COVID-19. It is feasible, portable with an accepted rate of sensitivity. However, it is advisable to be used as an integrated diagnostic tool.

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Section: Disucssionmentioning

confidence: 99%

Ultrasound in Suspected Pneumonic COVID-19: Our Experience

Alrifai

El-Raey

Yousef

et al. 2020

International Journal of Medical Arts

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“…Although chest tomography (CT) is the reference standard for diagnosis, LU has been shown to be useful in the pre-hospital setting [ 2 ] and upon hospital admission of COVID-19 patients [ 3 , 4 ]. Respiratory COVID-19 symptoms may persist for at least 60 days in 67% of patients [ 5 ], and while repeat CT may be impractical and/or unsafe for patients and operators, LU may be the default imaging modality for monitoring patients’ condition throughout their hospital stay and, if needed, after discharge [ 6 ]. Agreement with CT seems to be more than adequate in SARS-CoV-2-related pneumonia [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Is lung ultrasound score a useful tool to monitoring and handling moderate and severe COVID-19 patients in the general ward? An observational pilot study

Baciarello

Bonetti

Vetrugno

et al. 2021

J Clin Monit Comput

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Lung ultrasound is a well-established diagnostic tool in acute respiratory failure, and it has been shown to be particularly suited for the management of COVID-19-associated respiratory failure. We present exploratory analyses on the diagnostic and prognostic performance of lung ultrasound score (LUS) in general ward patients with moderate-to-severe COVID-19 pneumonia receiving O2 supplementation and/or noninvasive ventilation. From March 10 through May 1, 2020, 103 lung ultrasound exams were performed by our Forward Intensive Care Team (FICT) on 26 patients (18 males and 8 females), aged 62 (54 – 76) and with a Body Mass Index (BMI) of 30.9 (28.7 – 31.5), a median 6 (5 – 9) days after admission to the COVID-19 medical unit of the University Hospital of Parma, Italy. All patients underwent chest computed tomography (CT) the day of admission. The initial LUS was 16 (11 – 21), which did not significantly correlate with initial CT scans, probably due to rapid progression of the disease and time between CT scan on admission and first FICT evaluation; conversely, LUS was significantly correlated with PaO2/FiO2 ratio throughout patient follow-up [R = − 4.82 (− 6.84 to − 2.80; p < 0.001)]. The area under the receiving operating characteristics curve of LUS for the diagnosis of moderate-severe disease (PaO2/FiO2 ratio ≤ 200 mmHg) was 0.73, with an optimal cutoff value of 11 (positive predictive value: 0.98; negative predictive value: 0.29). Patients who eventually needed invasive ventilation and/or died during admission had significantly higher LUS throughout their stay.

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“…As the disease progresses, the sonographic appearances of pleural line irregularities are more intense, and B lines artifacts and subpleural consolidations increase in frequency and size [ 17 , 18 ]. In our study, we have followed a simplified examination protocol derived from a previous one proposed by Soldati et al [ 19 ]. In our experience, in a significant proportion of patients, it is difficult to obtain a good view of the axillary region and the left antero-inferior sector which is usually occupied by the heart.…”

Section: Discussionmentioning

confidence: 99%

Prediction Accuracy of Serial Lung Ultrasound in COVID-19 Hospitalized Patients (Pred-Echovid Study)

Torres‐Macho

Sánchez-Fernández

Arnanz-González

et al. 2021

JCM

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The value of serial lung ultrasound (LUS) in patients with COVID-19 is not well defined. In this multicenter prospective observational study, we aimed to assess the prognostic accuracy of serial LUS in patients admitted to hospital due to COVID-19. The serial LUS protocol included two examinations (0–48 h and 72–96 h after admission) using a 10-zones sequence, and a 0 to 5 severity score. Primary combined endpoint was death or the need for invasive mechanical ventilation. Calibration (Hosmer–Lemeshow test and calibration curves), and discrimination power (area under the ROC curve) of both ultrasound exams (SCORE1 and 2), and their difference (DIFFERENTIAL-SCORE) were performed. A total of 469 patients (54.2% women, median age 60 years) were included. The primary endpoint occurred in 51 patients (10.9%). Probability risk tertiles of SCORE1 and SCORE2 (0–11 points, 12–24 points, and ≥25 points) obtained a high calibration. SCORE-2 showed a higher discrimination power than SCORE-1 (AUC 0.72 (0.58–0.85) vs. 0.61 (0.52–0.7)). The DIFFERENTIAL-SCORE showed a higher discrimination power than SCORE-1 and SCORE-2 (AUC 0.78 (0.66–0.9)). An algorithm for clinical decision-making is proposed. Serial lung ultrasound performing two examinations during the first days of hospitalization is an accurate strategy for predicting clinical deterioration of patients with COVID-19.

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The role of lung ultrasonography in COVID‐19 disease management

Cited by 18 publications

References 34 publications

Ultrasound in Suspected Pneumonic COVID-19: Our Experience

Ultrasound in Suspected Pneumonic COVID-19: Our Experience

Is lung ultrasound score a useful tool to monitoring and handling moderate and severe COVID-19 patients in the general ward? An observational pilot study

Prediction Accuracy of Serial Lung Ultrasound in COVID-19 Hospitalized Patients (Pred-Echovid Study)

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