Lung ultrasound as diagnostic tool for SARS-CoV-2 infection

Abstract

The aim of this study was to explore the role of lung ultrasound (LUS) in the diagnosis of SARS-CoV-2 infection and to verify its utility in the prediction of lung disease's severity and outcome. Fifty-three consecutive patients presenting to the Emergency Department of Santa Maria delle Grazie Hospital with high suspicion of SARS-CoV-2 infection underwent diagnostic test for SARS-CoV-2 on samples obtained from nasopharyngeal swab as well as complete proper diagnostic work-up that included clinical evaluation, laboratory tests, blood gas analyses, chest CT and LUS. A semiquantitative analysis of B-lines distribution was performed to calculate the LUS score. Patients were divided into two groups according to the results of both SARS-CoV-2 diagnostic test and other exams (Group A = pneumonia due to SARS-CoV2 infection vs Group B = no SARS-CoV2 infection and another definite diagnosis). LUS showed an excellent accuracy in predicting the diagnosis of SARS-CoV-2 infection (area under the ROC curve of 0.92 with a sensibility of 73% and a specificity of 89% a the cutoff of 12.5). LUS score was more impaired in SARS-CoV-2 patients (18.1 ± 6.0 vs 7.6 ± 5.9, p < 0.00001) and it is significantly negatively correlated with PF ratio values (r = − 0.719, p < 0.0001). An intrahospital mortality rate of 46% was found; patients with adverse outcome had significant higher value of LUS, PF, LDH, and APACHE II score. None of these parameters was predictive of mortality. LUS is a useful tool for the early detection of SARS-CoV-2 infection and for the evaluation of the disease severity, but does not predict mortality. Further studies with repeated evaluations of LUS score are needed to further explore the role of LUS in the assessment of severity in SARS-CoV-2 disease and in the monitoring of the response to treatments.

Lung Ultrasound in COVID-19: Clinical Correlates and Comparison with Chest Computed Tomography

“…Previous studies in COVID-19 showed that LUS semi-quantitative evaluation provided useful diagnostic [ 14 ] and prognostic [ 15 , 16 ] information, while it correlated well with worsening respiratory insufficiency [ 14 ]. In our sample, we reported similar results; however, in comparison to others [ 14 , 15 ], we observed lower values of LUS scores and higher PaO2/FiO2, possibly partly explained by the non-critical care setting of our population [ 9 ]. Of note, COVID-19 is featured by quite heterogeneous clinical behavior, ranging from asymptomatic cases to different degrees of flu-like symptomatology and bilateral pneumonia complicated by respiratory failure [ 5 , 11 ].…”

COVID-19: persistence of symptoms and lung alterations after 3–6 months from hospital discharge

“…Thoracic ultrasound (US) was used to assess the presence of residual lung abnormalities. The sonographic examination was performed according to the protocol described by Bosso et al A convex or linear array probes were used to explore 12 wall zones, 6 per side, with the patient in a sitting position [ 13 ]. Each zone was scored according to the lung US pattern (score 0: presence of A-lines or fewer than 3 isolated B-lines, score 1: presence of multiple well-spaced B-lines, score 2: presence of coalescent B-lines, score 3: presence of lung consolidation).…”

COVID-19 Pandemic: Review of Contemporary and Forthcoming Detection Tools

“…Multiple studies are advocating radiologic imaging such as chest radiograph (CXR), chest ultrasound (US), lung ultrasound (LUS), and particularly chest computed tomography (chest CT) as complementary and, in some cases, as standard diagnosis method of COVID-19. [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] Patients who developed COVID-19 pneumonia shared similar lung abnormalities. 48 Peripheral ground-glass opacities, multiple bilateral consolidation, crazy paving patterns, and reticular pattern are standard features found in chest CT of pneumonia patients.…”