Thoracic ultrasound and SARS-COVID-19: a pictorial essay

Sofia, Soccorsa; Boccatonda, Andrea; Montanari, Marco; Spampinato, Michele Domenico; D’Ardes, Damiano; Cocco, Giulio; Accogli, Esterita; Cipollone, Francesco; Schiavone, Cosima

doi:10.1007/s40477-020-00458-7

Cited by 85 publications

(127 citation statements)

References 22 publications

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“…Even if a pathognomonic sign of SARS-CoV-2 lacks, the most common findings at LUS are the thickening of the pleurae and the appearance of B-lines and lung consolidations while pleural effusion is rarely reported. On further investigation, we found that the LUS score is more increased in anterior and lateral areas, which are non-gravity-dependent regions of lung aeration loss caused by an inflammatory response related to increased lung permeability [13]. From a pathophysiological point of view, changes in the lung parenchyma begin in the distal regions of the lung and progress proximally [14].…”

Section: Discussionmentioning

confidence: 75%

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

et al. 2020

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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.

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Section: Discussionmentioning

confidence: 75%

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

et al. 2020

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“…Following the ongoing active exploration of the diagnostic role of ChUS in the COVID-19 pandemic, clinical and sonographic classification of COVID-19 pneumonia was recently suggested. [10].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Chest Ultrasound and Standard X-Ray Imaging in COVID-19 Patients

Shumilov

Hosseini

Petzold

et al. 2020

Ultrasound Int Open

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The COVID-19 pandemic poses new challenges for the medical community due to its large number of patients presenting with varying symptoms. Chest ultrasound (ChUS) may be particularly useful in the early clinical management in suspected COVID-19 patients due to its broad availability and rapid application. We aimed to investigate patterns of ChUS in COVID-19 patients and compare the findings with results from chest X-ray (CRX).24 patients (18 symptomatic, 6 asymptomatic) with confirmed SARS-CoV-2 by polymerase chain reaction underwent bedside ChUS in addition to CRX following admission. Subsequently, the results of ChUS and CRX were compared.94% (n=17/18) of patients with respiratory symptoms demonstrated lung abnormalities on ChUS. ChUS was especially useful to detect interstitial syndrome compared to CXR in COVID-19 patients (17/18 vs. 11/18; p<0.02). Of note, ChUS also detected lung consolidations very effectively (14/18 for ChUS vs. 7/18 cases for CXR; p<0.02). Besides pathological B-lines and subpleural consolidations, pleural line abnormality (89%; n=16/18) was the third most common feature in patients with respiratory manifestations of COVID-19 detected by ChUS.Our findings support the high value of ChUS in the management of COVID-19 patients.

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“…COVID-19 has been previously described as a high rate infection disease with several systemic complications [2,5,6]. Even though chest X-ray and CT-scans are widely used in the primary instrumental assessment of COVID-19 patients [7,8,9], emerging evidences have explored the role of ultrasound in the diagnosis and treatment [10,11,12]. Frequent abnormal ultrasound imaging findings such as B-lines, consolidation areas or alteration of the pleural line have been recently characterized [12].…”

Section: Discussionmentioning

confidence: 99%

“…Even though chest X-ray and CT-scans are widely used in the primary instrumental assessment of COVID-19 patients [7,8,9], emerging evidences have explored the role of ultrasound in the diagnosis and treatment [10,11,12]. Frequent abnormal ultrasound imaging findings such as B-lines, consolidation areas or alteration of the pleural line have been recently characterized [12]. On the other hand, ultrasound may produce a real-time and dynamic evaluation, even in cases with critical complications of severe COVID-19 pneumonia, such as pneumothorax.…”

Section: Discussionmentioning

confidence: 99%

2019 Novel Coronavirus (COVID-19) pneumonia: an unusual lung ultrasound presentation.

Consoli

Bendotti

Cicchinelli

et al. 2020

Preprint

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In December 2019, a novel coronavirus (SARS-Cov-2) was first reported in Wuhan, China, and rapidly spread around the world, leading to an international emerging public health emergency. As reported from Chinese experiences, approximately 20% of patients had a severe course, requiring intensive care, with an overall case fatality rate of 2.3%. In diagnosis, chest computed tomography most commonly showed ground-glass opacity with or without consolidative patterns.Herein we report a case of a patient affected by COVID-19 pneumonia referred in the emergency department of our institution on 4 April 2020 with peculiar lung ultrasound findings.

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Thoracic ultrasound and SARS-COVID-19: a pictorial essay

Cited by 85 publications

References 22 publications

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

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

Comparison of Chest Ultrasound and Standard X-Ray Imaging in COVID-19 Patients

2019 Novel Coronavirus (COVID-19) pneumonia: an unusual lung ultrasound presentation.

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