The value of lung ultrasound in COVID-19 pneumonia, verified by high resolution computed tomography assessed by artificial intelligence

Abstract

Background Lung ultrasound (LUS) is an increasingly popular imaging method in clinical practice. It became particularly important during the COVID-19 pandemic due to its mobility and ease of use compared to high-resolution computed tomography (HRCT). The objective of this study was to assess the value of LUS in quantifying the degree of lung involvement and in discrimination of lesion types in the course of COVID-19 pneumonia as compared to HRCT analyzed by the artificial intelligence (AI). Methods This was a prospective observational study including adult patients hospitalized due to COVID-19 in whom initial HRCT and LUS were performed with an interval < 72 h. HRCT assessment was performed automatically by AI. We evaluated the correlations between the inflammation volume assessed both in LUS and HRCT, between LUS results and the HRCT structure of inflammation, and between LUS and the laboratory markers of inflammation. Additionally we compared the LUS results in subgroups depending on the respiratory failure throughout the hospitalization. Results Study group comprised 65 patients, median 63 years old. For both lungs, the median LUS score was 19 (IQR—interquartile range 11–24) and the median CT score was 22 (IQR 16–26). Strong correlations were found between LUS and CT scores (for both lungs r = 0.75), and between LUS score and percentage inflammation volume (PIV) (r = 0.69). The correlations remained significant, if weakened, for individual lung lobes. The correlations between LUS score and the value of the percentage consolidation volume (PCV) divided by percentage ground glass volume (PGV), were weak or not significant. We found significant correlation between LUS score and C-reactive protein (r = 0.55), and between LUS score and interleukin 6 (r = 0.39). LUS score was significantly higher in subgroups with more severe respiratory failure. Conclusions LUS can be regarded as an accurate method to evaluate the extent of COVID-19 pneumonia and as a promising tool to estimate its clinical severity. Evaluation of LUS in the assessment of the structure of inflammation, requires further studies in the course of the disease. Trial registration The study has been preregistered 13 Aug 2020 on clinicaltrials.gov with the number NCT04513210.

The utility of lung ultrasound in COVID-19 pneumonia in the intensive care unit in real life settings

“…Furthermore, the same dissociation was observed retrospectively in ARDS before the COVID-19 pandemic 27 and not only in the early phase of ARDS, but also in persistent ARDS 28 . The lack of LUS correlation with CRP, a systemic marker of inflammation, contrasts with previous studies where LUS was positively associated with CRP levels 29,30 . However, these studies were performed in patients admitted to the hospital ward, whereas in our study critically ill patients were included upon ICU admission, therefore CRP levels could be affected by prior in-hospital treatments.…”

Evaluation of a Lung Ultrasound Score in Hospitalized Adult Patients with COVID-19 in Barcelona, Spain

“…Furthermore, the operator variability could be addressed through the advancements in artificial intelligence (AI) applied to LUS. These developments have been demonstrated in assessing the extend of COVID-19 pneumonia [ 41 ] and diagnosing COVID-19 pneumonia compared to CT [ 42 ].…”

“…Similar studies conducted in LMICs countries would provide evidence to support building the capacity of their healthcare professionals to use LUS in the management of COVID-19 [ 38 ]. Moreover, the advances in AI could be applied even in novice observers [ 42 ] and is a promising tool to estimate clinical severity [ 41 ]. Further studies are also needed to evaluate the use of LUS after the introduction of COVID-19 vaccines and the recent virus variants that have led to a reduced severity of COVID-19.…”