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

Lugarà, Marina; Tamburrini, Stefania; Coppola, Maria Gabriella; Oliva, Gabriella; Fiorini, Valeria; Catalano, Marco; Carbone, Roberto; Saturnino, Pietro Paolo; Rosano, Nicola; Pesce, A.; Galiero, Raffaele; Ferrara, Roberta; Iannuzzi, Michele; Vincenzo, D’Agostino; Negro, Alberto; Somma, Francesco; Fasano, Fabrizio; Perrella, Alessandro; Vitiello, Giuseppe; Sasso, Ferdinando Carlo; Rinaldi, Gino Soldati and Luca

doi:10.3390/diagnostics12081856

Cited by 9 publications

(7 citation statements)

References 53 publications

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“…We conducted LUS follow-up in a small number of COVID-19 pneumonia patients and found that the LUS score decreased significantly after LI-PUS treatment (median: 12 vs. 2, p < 0.001) (Supplementary Figure 3). Lugarà et al [26] performed LUS scores and high-resolution CT scores on 99 patients with COVID-19 pneumonia, and the results also showed a significant correlation and synergy between the two in the diagnosis and the assessment of disease severity. It can be seen that LUS combined with chest CT for pneumonia diagnosis and localization and guidance of LIPUS treatment will further improve the curative effect.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of low-intensity pulsed ultrasound in the treatment of COVID-19 pneumonia

Li,

Kong

et al. 2023

Ultraschall Med

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Purpose As a public health emergency of international concern, the coronavirus disease 2019 (COVID-19) still lacks specific antiviral drugs, and symptomatic treatment is currently the mainstay. The overactivated inflammatory response in COVID-19 patients is associated with a high risk of critical illness or even death. Low-intensity pulsed ultrasound (LIPUS) can mitigate inflammation and inhibit edema formation. We aimed to investigate the efficacy of LIPUS therapy for COVID-19 pneumonia. Material and methods 62 patients were randomly assigned into a treatment group (LIPUS treatment area - Group 1; self-control area - Group 2) and an external control group (Group 3). Primary outcomes were the volume absorption rate (VAR) and the area absorption rate (AAR) of lung inflammation in CT images. Results Average 7.2 days of treatment, there were significant differences in AAR and VAR between Group 1 and Group 2 (AAR 0.25 vs 0.12, p=0.013; VAR 0.35 vs 0.11, p=0.005), and between Group 1 and Group 3 (AAR 0.25 vs 0.11, p=0.047; VAR 0.35 vs 0.19, p=0.042). Neither AAR nor VAR was statistically different between Group 2 and Group 3. After treatment, C-reactive protein, interleukin-6, leukocyte and fingertip arterial oxygen saturation (SaO2) improved in Group 1, while in Group 3 only fingertip SaO2 increased. Conclusion LIPUS therapy reduced lung inflammation and serum inflammatory factor levels in hospitalized COVID-19 patients, which might be a major advance in COVID-19 pneumonia therapy.

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Section: Discussionmentioning

confidence: 99%

Efficacy of low-intensity pulsed ultrasound in the treatment of COVID-19 pneumonia

Li,

Kong

et al. 2023

Ultraschall Med

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“…Another important reason to support the use of LUS, instead of CXRs, in the corona score for patients with suspected COVID-19 is to reduce the risk associated with transporting unstable patients to radiology. This would further act to reduce nosocomial outbreaks due to this highly contagious virus [ 27 ]. A recent study underlined the concept that modern radiology rooms have become a “meeting point” where it is all too easy for cross-infection to occur.…”

Section: Discussionmentioning

confidence: 99%

A Modified Corona Score Using Lung Ultrasound to Identify COVID-19 Patients

Caroselli,

Blaivas,

Tung Chen

et al. 2023

Diagnostics

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Background: COVID-19 continues to circulate around the world with multiple different strains being active at once. While diagnosis with antigen and molecular testing is more readily available, there is still room for alternative methods of diagnosis, particularly in out-of-hospital settings, e.g., home or nursing homes, and in low–medium income countries, where testing may not be readily available. Study Objectives: To evaluate the performance of two modified corona score methods compared with a traditional corona score approach to identify patients with COVID-19. Methods: This was a retrospective multicenter study performed to compare the ability to predict SARS-CoV-2 test results on a nasopharyngeal swab between the corona scores and two novel corona scores (modified 1 corona score (M1CS) and modified 2 corona score (M2CS)). The M1CS included lung ultrasound (LUS) and chest X-ray (CXR) results, while the M2SC only utilized LUS findings without CXRs. Emergency physicians performed point-of-care LUS and a physical examination upon admission to the emergency department. Results: Subjects positive for SARS-CoV-2 were older and had higher ferritin levels and temperature and lower diastolic blood pressure and oxygen saturation. The two groups differed on corona score and modified corona scores (p < 0.001 for all). SARS-CoV-2-positive patients had fewer pleural line irregularities (p = 0.025) but presented more frequently with an interstitial pattern on CXRs (p < 0.001). Conclusions: In our study, LUS alone provided a valuable contribution to the corona score and improved its performance more than when CXR results were included. These results suggest that resource-limited areas where CXRs may be unavailable or prohibitively expensive can utilize an ultrasound as the sole imaging modality without a loss of diagnostic performance for SARS-CoV-2 pneumonia diagnosis.

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“…[33][34][35] Yet, studies that evaluated the combined prognostic role of pro-BNP and LUS score toward morbidity and mortality for PE or acute respiratory distress syndrome in inpatients with COVID-19 are lacking and with non-univocal results, in particular, because COVID-19 has been associated with an excess of PE per se since first wave. [36][37][38][39][40] Probably, because of the high impact of the pandemic also the role of traditional biomarkers (i.e., troponin and D-dimer) in this clinical setting has been doubtful and for this reason, epidemiological studies looking for other prognostic biomarkers are still active. 9,32 Therefore, in this report, we addressed our goals to identify a possible combined role of values of pro-BNP and LUS score in inpatients with COVID-19 in a regular ward or in sub-intensive areas in order to identify patients at high risk to die for PE.…”

Section: Discussionmentioning

confidence: 99%

Lung ultrasound scan score can identify pulmonary embolism high risk in patients with COVID-19: a retrospective analysis from a single center

Coppola

Cardillo²,

Lugarà

et al. 2023

Ital J Med

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Background. Since the European Society of Cardiology (ESC) published guidelines to stratify the risk of pulmonary embolism (PE), the main goal of several physicians has been to find a biomarker able to identify patients with venous thromboembolism at high risk to die. Increased levels of pro-B-type natriuretic peptide (BNP) were suggested as useful biomarkers in the guidelines of ESC (i.e., 2014) to identify patients with PE at high risk of death, but its role was not confirmed in other guidelines. Lung Ultrasound Scan (LUS) has been suggested as a diagnostic and prognostic test to identify patients with a high risk of mortality for lung failure. The aim of this study is to evaluate the prognostic role of pro- BNP together with the LUS evaluation in patients with COVID-19 and PE in particular regarding mortality for pulmonary embolism and overall death. Patients and Methods. We retrospectively analyzed records from 178 patients with confirmed COVID-19, admitted to our ward (i.e., COVID Medicine Unit at Ospedale del Mare in the town of Napoli) between March 2020 and May 2021. For this study, we analyzed the LUS data of all 178 patients and the available data on the pro-BNP of 120 patients. For all selected patients, mortality for PE and overall deaths were recorded. Results. The Propensity Score Matching was used to minimize and erase confounding factors. Data showed that an association between serum levels of pro-BNP and pulmonary thrombotic events was neither present before nor after matching an association with adverse outcomes and was found for increased values of LUS. Discussion. During the first waves of the pandemic, patients with confirmed COVID-19 with severe lung failure frequently showed pulmonary embolism as a clinical acute complication inducing life-threatening evolution. Conclusions. An association between LUS score and severe PE and/or overall mortality in hospitalized patients with COVID-19 was found while a similar association was not confirmed for pro-BNP.

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

Cited by 9 publications

References 53 publications

Efficacy of low-intensity pulsed ultrasound in the treatment of COVID-19 pneumonia

Efficacy of low-intensity pulsed ultrasound in the treatment of COVID-19 pneumonia

A Modified Corona Score Using Lung Ultrasound to Identify COVID-19 Patients

Lung ultrasound scan score can identify pulmonary embolism high risk in patients with COVID-19: a retrospective analysis from a single center

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