Abstract
Background: Interstitial lung sequelae are increasingly being reported in survivors of COVID-19 pneumonia. An early detection of these lesions may help prevent the development of irreversible lung fibrosis. Lung ultrasound (LUS) has shown high diagnostic accuracy in interstitial lung disease (ILD) and could likely be used as a first-line test for post-COVID-19 lung sequelae.Methods: Single-center observational prospective study. Follow-up assessments of consecutive patients hospitalized for COVID-19 pneumonia were conducted 2–5 months after the hospitalization. All patients underwent pulmonary function tests (PFTs), high-resolution computed tomography (HRCT), and LUS. Radiological alterations in HRCT were quantified using the Warrick score. The LUS score was obtained by evaluating the presence of pathological B-lines in 12 thoracic areas (range, 0–12). The correlation between the LUS and Warrick scores was analyzed.Results: Three hundred and fifty-two patients who recovered from COVID-19 pneumonia were recruited between July and September 2020. At follow-up, dyspnea was the most frequent symptom (69.3%). FVC and DLCO alterations were present in 79 (22.4%) and 234 (66.5%) patients, respectively. HRCT showed relevant interstitial lung sequelae (RILS) in 154 (43.8%) patients (Warrick score ≥ 7). The LUS score was strongly correlated with the HRCT Warrick score (r = 0.77) and showed a moderate inverse correlation with DLCO (r = −0.55). The ROC curve analysis revealed that a LUS score ≥ 3 indicated an excellent ability to discriminate patients with RILS (sensitivity, 94.2%; specificity, 81.8%; negative predictive value, 94.7%).Conclusions: LUS could be implemented as a first-line procedure in the evaluation of Post-COVID-19 interstitial lung sequelae. A normal LUS examination rules out the presence of these sequelae in COVID-19 survivors, avoiding the need for additional diagnostic tests such as HRCT.
Highlights
The global coronavirus disease 2019 (COVID-19) pandemic has reached unprecedented dimensions, with more than 246 million cases and 5 million deaths worldwide [1]
Three-hundred and sixty-two patients who had recovered from COVID-19 pneumonia after hospitalization were evaluated
The median duration (IQR) of hospitalization was 9.5 [6.0–21.0] days, and 115 (32.7%) patients were admitted to the intensive care unit (ICU), with a median hospitalization period of 12 [6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21] days
Summary
The global coronavirus disease 2019 (COVID-19) pandemic has reached unprecedented dimensions, with more than 246 million cases and 5 million deaths worldwide [1]. In previous viral epidemics such as those caused by MERSCoV and SARS-CoV, a variable percentage of survivors developed interstitial lung disease (ILD), including pulmonary fibrosis (PF) [5,6,7,8,9]. Several recent reports have described early respiratory sequelae following COVID-19, such as persistent symptoms, impaired pulmonary function, and interstitial lung abnormalities [10,11,12,13,14,15,16]. Lung ultrasound (LUS) has shown high diagnostic accuracy in interstitial lung disease (ILD) and could likely be used as a first-line test for post-COVID-19 lung sequelae
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
