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

Abstract

Purpose To identify the defining lung ultrasound (LUS) findings of COVID-19, and establish its association to the initial severity of the disease and prognostic outcomes. Method Systematic review was conducted according to the PRISMA guidelines. We queried PubMed, Embase, Web of Science, Cochrane Database and Scopus using the terms ((coronavirus) OR (covid-19) OR (sars AND cov AND 2) OR (2019-nCoV)) AND ((“lung ultrasound”) OR (LUS)), from 31st of December 2019 to 31st of January 2021. PCR-confirmed cases of SARS-CoV-2 infection, obtained from original studies with at least 10 participants 18 years old or older, were included. Risk of bias and applicability was evaluated with QUADAS-2. Results We found 1333 articles, from which 66 articles were included, with a pooled population of 4687 patients. The most examined findings were at least 3 B-lines, confluent B-lines, subpleural consolidation, pleural effusion and bilateral or unilateral distribution. B-lines, its confluent presentation and pleural abnormalities are the most frequent findings. LUS score was higher in intensive care unit (ICU) patients and emergency department (ED), and it was associated with a higher risk of developing unfavorable outcomes (death, ICU admission or need for mechanical ventilation). LUS findings and/or the LUS score had a good negative predictive value in the diagnosis of COVID-19 compared to RT-PCR. Conclusions The most frequent ultrasound findings of COVID-19 are B-lines and pleural abnormalities. High LUS score is associated with developing unfavorable outcomes. The inclusion of pleural effusion in the LUS score and the standardisation of the imaging protocol in COVID-19 LUS remains to be defined.

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

“…This study considered a broader population spectrum admitted to the emergency department with only 74 ICU patients [ 15 ]. In a recent review, a higher baseline LUS score is related to a higher risk of unfavorable outcomes (ICU admission, mechanical ventilation, and death) [ 16 ].…”

COVID-19 related maternal mortality cases in associated with Delta and Omicron waves and the role of lung ultrasound

“…Besides, a significant correlation was found between clinical severity and LUS scores. ICU admission, mechanical ventilation and mortality were linked to higher LUS scores, according to a recently published review ( 18 ) .…”

“…LUS is a new thoracic imaging method that is becoming more widely used than other thoracic imaging modalities. Its usage to determine the pulmonary involvement in COVID-19 has increased recently ( 18 ) . Abnormal LUS findings were found relevant to early admission into intensive care units (ICU) or ICU and mortality in the pandemic ( 16 , 18 ) .…”

Feasibility, Prediction and Association of Right Ventricular Free Wall Longitudinal Strain with 30-Day Mortality in Severe COVID-19 Pneumonia: A Prospective Study

“…The Bleakly study assessed RV systolic function in critically ill COVID-19 patients, and the feasibility was 57% (49/90) [12]. This poor feasibility rate can be explained by the following factors: firstly, in the ICU, the adequate acoustic window is often impaired by mechanical ventilation, COVID-19 lung injuries (B lines, subpleural consolidation [27]), and suboptimal patient positioning. Secondly, RV-FWLS measurement requires an RV-focused four-chamber apical view, obtained with a more lateral transducer position than that used for a conventional apical-four chamber view [6], which is challenging in sedated and curarized patients.…”