Comparison between Lung Ultrasound and Chest Computed Tomography in the Assessment of Severity of Confirmed Coronavirus COVID-19 Pneumonia

Abstract

Background Coronavirus disease 2019 (COVID-19) was reported for the first time in the Chinese province of Wuhan and then rapidly spread worldwide, to be declared a pandemic on March 11, 2020. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which has a genome similar to that of the RNA virus group that caused SARS and Middle East respiratory syndrome. Aim of the Work The aim of this study was to determine the correlation between LUS and CT findings in SARS-CoV-2 infection, to assess the performance of lung ultrasound (LUS) to classify lung abnormalities and to evaluate the possibility of using this technique to provide a quantitative assessment of pulmonary involvement in COVID-19 patients. Patients and Methods This was a cross sectional study that included 30 patients who had symptoms of variable degree of fever, cough, and dyspnea with RT-PCR confirmed COVID19 infection by nasopharyngeal swab on admission or during hospitalisation either at ward or intensive care unit (ICU) at Ain Shams University Hospitals and National Hepatology and Tropical Medicine Research Institute from May 2021 to March 2022, for whom CT chest was ordered before admission. An acceptance from the ethical committee of the Radiology Department and the ethical committee of Faculty of Medicine - Ain Shams University and NHTMRI was obtained to use the data stored on PACS with the patient’s consent to perform lung ultrasound. Patients who did not perform PCR test, age <18years, those with known history of interstitial lung disease or with previous lung and thoracic wall surgery, anatomically having thoracic wall abnormalities and patients who did not consent to participate in the study were not included in the study. Results This study showed that in a sample of patients with PCR proven COVID-19, Patients with respiratory symptoms or comorbidities tended to have more changes on LUS and more extensive disease on CT. There was a relationship between the abnormalities detected by the imaging modalities; In addition, LUS score is associated with severity as assessed by chest CT scan and clinical features Conclusion The advantages of ultrasonography compared to CT include portability, no exposure to radiation (pregnant women and patients with extra risk for radiation use), low cost, no need for auxiliary personnel, and repeatability. Thus, it can be used as an alternative to CT chest in severe cases (especially ICU cases).