Abstract
The COVID-19 pandemic has increased the need for an accessible, point-of-care and accurate imaging modality for pulmonary assessment. COVID-19 pneumonia is mainly monitored with chest X-ray, however, lung ultrasound (LUS) is an emerging tool for pulmonary evaluation. In this study, patients with verified COVID-19 disease hospitalized at the intensive care unit and treated with ventilator and extracorporal membrane oxygenation (ECMO) were evaluated with LUS for pulmonary changes. LUS findings were compared to C-reactive protein (CRP) and ventilator settings. Ten patients were included and scanned the day after initiation of ECMO and thereafter every second day until, if possible, weaned from ECMO. In total 38 scans adding up to 228 cineloops were recorded and analyzed off-line with the use of a constructed LUS score. The study indicated that patients with a trend of lower LUS scores over time were capable of being weaned from ECMO. LUS score was associated to CRP (R = 0.34; p < 0.03) and compliance (R = 0.60; p < 0.0001), with the strongest correlation to compliance. LUS may be used as a primary imaging modality for pulmonary assessment reducing the use of chest X-ray in COVID-19 patients treated with ventilator and ECMO.
Highlights
In December 2019, several cases of a severe pneumonia were reported in Wuhan, China
The novel coronavirus was named SARS-CoV-2 by the World Committee on Virus Classification, and the disease caused by the virus was named COVID-19 by the World Health Organization [2]
Ten patients were included in the study, and all patients were scanned the day after initiation of VV-extracorporal membrane oxygenation (ECMO) and thereafter every second day until, if possible, being weaned from VV-ECMO
Summary
Analyses of the patients revealed that a novel coronavirus was the cause of the outbreak [1]. The novel coronavirus was named SARS-CoV-2 by the World Committee on Virus Classification, and the disease caused by the virus was named COVID-19 by the World Health Organization [2]. The coronavirus with a crown shaped viral envelope, has a high infectivity and can cause a variety of symptoms; headache, dry cough, dyspnea, myalgia, fatigue and fever are reported [1,2]. Imaging of the coronavirus pneumonia has mainly concerned computed tomography (CT) and chest X-ray [3,4,5]. Previous imaging studies show that patients with COVID-19 exhibit subpleural consolidations with ground glass opacities (GGO), interlobular septal thickening, crazy paving and pleural thickening
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