Characteristics of Pulmonary Auscultation in Patients with 2019 Novel Coronavirus in China

Abstract

Background: Effective auscultation are often hard to implement in isolation wards. To date, little is known about the characteristics of pulmonary auscultation in novel coronavirus (COVID-19) pneumonia. The aim of this study was to explore the clinical feasibility of electronic stethoscopes in isolation wards and the features of pulmonary auscultation in COVID-19 pneumonia. Methods: This cross-sectional, observational study was conducted among patients with laboratory-confirmed COVID-19 at Wuhan Red-cross Hospital during the period from January 27, 2020 to February 12, 2020. Standard auscultation with an electronic stethoscope was performed and electronic recordings of breath sounds were analyzed. Findings: 57 patients with average age of 60.6 years were enrolled. The most common symptoms was cough (73.7%) during auscultation. Most cases had bilateral lesions (96.4%) such as multiple ground-glass opacity (69.1%) and fibrous stripes (21.8%). High-quality auscultation recordings (98.8%) were obtained and coarse breath sounds, wheezes, medium-coarse crackles, fine crackles and Velcro crackles were identified. The distribution of coarse breath sounds was equivalent, while crackles occurred more frequently in basal lungs. Most cases had normal breath sounds in upper lungs, but the proportions of abnormal breath sounds increased in the basal fields where Velcro crackles were more commonly identified at the posterior chest. Interpretation: The present study describes common abnormalities in breath sounds and their distribution characteristics using electronic stethoscope, which to some extent provides insights into the pathophysiological and clinical process of the disease, suggesting that electronic auscultation can be readily applied at bedside in isolation wards to aid diagnosis and management of COVID-19 patients. Funding Statement: 1.3.5 project for disciplines of excellence, West China Hospital of Sichuan University (ZYJC18021). Declaration of Interests: The authors stated that there is no conflict of interest. Ethics Approval Statement: The study protocol conforms to the principles of the Declaration of Helsinki and was approved by the institutional ethics board of West China Hospital of Sichuan University (No. 2020-126). Written informed consent was collected from all patients.