Lung Ultrasound Examination in Patients with SARS-CoV-2 Infection: Multicenter Study

Buda, Natalia; Cylwik, Jolanta; Mróz, Katarzyna; Rudzińska, Renata; Dubik, Paweł; Malczewska, A.; Oraczewska, Aleksandra; Skoczyński, Szymon; Suska, Anna; Górecki, Tomasz; Mendrala, Konrad; Piotrkowski, Jakub; Gola, Wojciech; Segura‐Grau, Elena; Zamojska, Anna; Wełnicki, Marcin

doi:10.3390/jcm10153255

Cited by 11 publications

(8 citation statements)

References 22 publications

(21 reference statements)

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“…Active lesions in interstitial lung disease, visualized as the presence of “ground glass” in computed tomography, will also be represented as B lines arising from the normal pleural line in the ultrasound image. This happens in acute hypersensitivity pneumonitis, some cases of sarcoidosis, acute interstitial pneumonia, and alveolar hemorrhage [ 16 , 17 ].…”

Section: Discussion Between the Clinicians And The Engineermentioning

confidence: 99%

Vertical Artifacts in Lung Ultrasonography: Some Common Clinician Questions and the Related Engineer Answers

Demi

Buda

Soldati³

2022

Diagnostics

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Introduction: Vertical artifacts, including B lines, are frequently seen in a variety of lung diseases. Their sonomorphology varies in length, width, shape, and internal reverberations. The reason for this diversity is still unknown and is the cause of discussion between clinicians and ultrasound physics engineers. Aim: The aim of this work is to sum up the most common clinician observations and provide an explanation to each of them derived from ultrasound physics. Materials and Methods: Based on clinical and engineering experiences as well as data collected from relevant literature, the sonomorphology of vertical artifacts was analyzed. Thirteen questions and answers were prepared on the common sonomorphology of vertical artifacts, current nomenclature, and clinical observations. Conclusions: From a clinical standpoint, the analysis of vertical artifacts is very important and requires that further clinical studies be conducted in cooperation with engineers who specialize in physics.

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Section: Discussion Between the Clinicians And The Engineermentioning

confidence: 99%

Vertical Artifacts in Lung Ultrasonography: Some Common Clinician Questions and the Related Engineer Answers

Demi

Buda

Soldati³

2022

Diagnostics

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“…Experience with LUS in assessing COVID‐19 patients shows, however, that the alterations visualized in the posterior areas are the most significant 101 . Assessing each intercostal space along its entire length is time‐consuming, so reasonably simplified protocols have been suggested for COVID‐19 patients as well, such as 18 28–55,57–151 and 14 scan protocols 24,101 . Lately one interesting study on the correlation between LUS and laboratory results also described a protocol of 12 scans (quick COVID‐19 severity index [qCSI]), 6 for each half of the chest (upper and lower areas of the anterior, lateral and posterior surfaces, respectively), for assessing the presence of B‐line and/or consolidation 152 .…”

Section: Methodsmentioning

confidence: 99%

New International Guidelines and Consensus on the Use of Lung Ultrasound

Demi

Wolfram

Klersy

et al. 2022

J of Ultrasound Medicine

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116

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Following the innovations and new discoveries of the last 10 years in the field of lung ultrasound (LUS), a multidisciplinary panel of international LUS experts from six countries and from different fields (clinical and technical) reviewed and updated the original international consensus for point-of-care LUS, dated 2012. As a result, a total of 20 statements have been produced. Each statement is complemented by guidelines and future developments proposals. The statements are furthermore classified based on their nature as technical (5), clinical (11), educational (3), and safety (1) statements.

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“…Results of this study and other observations agree with this hypothesis. In practical terms, LUS can be considered an equally accurate alternative to CT in cases of COVID-19, particularly in situations where CT is not easily accessible or when molecular tests are not available [ 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of Lung Ultrasound in SARS-CoV-19 Pneumonia Management

Lugarà¹,

Tamburrini²,

Coppola³

et al. 2022

Diagnostics

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Purpose: We aimed to assess the role of lung ultrasound (LUS) in the diagnosis and prognosis of SARS-CoV-2 pneumonia, by comparing it with High Resolution Computed Tomography (HRCT). Patients and methods: All consecutive patients with laboratory-confirmed SARS-CoV-2 infection and hospitalized in COVID Centers were enrolled. LUS and HRCT were carried out on all patients by expert operators within 48–72 h of admission. A four-level scoring system computed in 12 regions of the chest was used to categorize the ultrasound imaging, from 0 (absence of visible alterations with ultrasound) to 3 (large consolidation and cobbled pleural line). Likewise, a semi-quantitative scoring system was used for HRCT to estimate pulmonary involvement, from 0 (no involvement) to 5 (>75% involvement for each lobe). The total CT score was the sum of the individual lobar scores and ranged from 0 to 25. LUS scans were evaluated according to a dedicated scoring system. CT scans were assessed for typical findings of COVID-19 pneumonia (bilateral, multi-lobar lung infiltration, posterior peripheral ground glass opacities). Oxygen requirement and mortality were also recorded. Results: Ninety-nine patients were included in the study (male 68.7%, median age 71). 40.4% of patients required a Venturi mask and 25.3% required non-invasive ventilation (C-PAP/Bi-level). The overall mortality rate was 21.2% (median hospitalization 30 days). The median ultrasound thoracic score was 28 (IQR 20–36). For the CT evaluation, the mean score was 12.63 (SD 5.72), with most of the patients having LUS scores of 2 (59.6%). The bivariate correlation analysis displayed statistically significant and high positive correlations between both the CT and composite LUS scores and ventilation, lactates, COVID-19 phenotype, tachycardia, dyspnea, and mortality. Moreover, the most relevant and clinically important inverse proportionality in terms of P/F, i.e., a decrease in P/F levels, was indicative of higher LUS/CT scores. Inverse proportionality P/F levels and LUS and TC scores were evaluated by univariate analysis, with a P/F–TC score correlation coefficient of −0.762, p < 0.001, and a P/F–LUS score correlation coefficient of −0.689, p < 0.001. Conclusions: LUS and HRCT show a synergistic role in the diagnosis and disease severity evaluation of COVID-19.

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Lung Ultrasound Examination in Patients with SARS-CoV-2 Infection: Multicenter Study

Cited by 11 publications

References 22 publications

Vertical Artifacts in Lung Ultrasonography: Some Common Clinician Questions and the Related Engineer Answers

Vertical Artifacts in Lung Ultrasonography: Some Common Clinician Questions and the Related Engineer Answers

New International Guidelines and Consensus on the Use of Lung Ultrasound

The Role of Lung Ultrasound in SARS-CoV-19 Pneumonia Management

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