Importance of Lung Ultrasound Follow-Up in Patients Who Had Recovered from Coronavirus Disease 2019: Results from a Prospective Study

Abstract

There is growing evidence regarding the imaging findings of coronavirus disease 2019 (COVID-19) in lung ultrasounds, however, their role in predicting the prognosis has yet to be explored. Our objective was to assess the usefulness of lung ultrasound in the short-term follow-up (1 and 3 months) of patients with SARS-CoV-2 pneumonia, and to describe the progression of the most relevant lung ultrasound findings. We conducted a prospective, longitudinal and observational study performed in patients with confirmed COVID-19 who underwent a lung ultrasound examination during hospitalization and repeated it 1 and 3 months after hospital discharge. A total of 96 patients were enrolled. In the initial ultrasound, bilateral involvement was present in 100% of the patients with mild, moderate or severe ARDS. The most affected lung area was the posteroinferior (93.8%) followed by the lateral (88.7%). Subpleural consolidations were present in 68% of the patients and consolidations larger than 1 cm in 24%. One month after the initial study, only 20.8% had complete resolution on lung ultrasound. This percentage rose to 68.7% at 3 months. Residual lesions were observed in a significant percentage of patients who recovered from moderate or severe ARDS (32.4% and 61.5%, respectively). In conclusion, lung injury associated with COVID-19 might take time to resolve. The findings in this report support the use of lung ultrasound in the short-term follow-up of patients recovered from COVID-19, as a radiation-sparing, easy to use, novel care path worth exploring.

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

“…Prior prospective studies investigating the serial changes in LUS findings during and after a COVID-19 infection, have reported similar findings regarding the gradual decrease in pathologic LUS findings from hospitalization to follow-up 1–4 months after discharge [ 35 , 38 ]. However, the proportion of patients with pathologic LUS findings post-discharge was higher in these serial LUS studies [ 35 , 38 ] as well as in another non-serial LUS study among COVID-19 survivors [ 34 ] compared to ours.…”

“…Our study may have been underpowered to detect a statistically significant difference between the follow-up LUS findings in patients with and without ARDS during the hospitalization. A prior study in hospitalized COVID-19 patients found that the improvement in LUS score at follow-up post-discharge was greater for those who did not have ARDS during the hospitalization compared to those who had varying degrees of ARDS during the hospitalization [ 35 ]. Thus, patients who have had ARDS may develop more persistent lung changes detectable on LUS at least 2–3 months after discharge.…”

Is Lung Ultrasound Helpful in COVID-19 Neonates?—A Systematic Review

“…Recently, LUS has proved its efficiency in the dynamic monitoring of COVID-19 pneumonia, as well as in the follow-up of patients recovered from this infection [ 63 , 64 ]. Moreover, a recent review proves the usefulness of hand-held ultrasound equipment, which has the advantage of lower acquisition costs and that is easy to decontaminate, which is a necessary activity nowadays [ 65 ].…”

Importance of point-of-care ultrasound in early diagnosis of COVID-19 complications

“…Third and finally, it shows how the use of POCUS allows for a faster diagnosis and quick detection of complications in both hospitalised and ambulatory patients, which leads to earlier and more directed treatment of these conditions that during the current pandemic is more important than ever before. 7 8 …”