Abstract
Background: The COVID-19 pandemic has, by necessity, contributed to rapid advancements in medicine. Owing to the necessity of following strict anti-epidemic sanitary measures when taking care of infected patients, the accessibility of standard diagnostic methods may be limited. Consequently, the significance and potential of bedside diagnostic modalities increase, including lung ultrasound (LUS). Method: Multicenter registry study involving adult patients with confirmed COVID-19, for whom LUS was performed. Results: A total of 228 patients (61% males) qualified for the study. The average age was 60 years (±14), 40% were older than 65 years of age. In 130 from 173 hospitalized patients, HRCT (high-resolution computed tomography) was performed. In 80% of patients, LUS findings indicated interstitial pneumonia. In hospitalized patients multifocally located single B-lines, symmetrical B-lines, and areas of white lung were significantly more frequent as compared to ambulatory patients. LUS findings, both those indicating interstitial syndrome and consolidations, were positively correlated with HRCT images. As compared to HRCT, the sensitivity and specificity of LUS in detecting interstitial pneumonia were 97% and 100%, respectively. Conclusions: As compared to HRCT, LUS is characterized by a very high sensitivity and specificity in detecting interstitial pneumonia in COVID-19 patients. Potentially, LUS can be a particularly useful diagnostic modality for COVID-19 patients pneumonia.
Highlights
Bilateral lung lesions are found in as many as 75% of patients with SARS-CoV-2 in a chest computed tomography (CT) scan [1]
Chest radiographs in COVID-19 patients depicted band or reticular changes and multifocal changes of a ground glass pattern
It is possible that chest radiography will not detect pulmonary interstitial involvement
Summary
Bilateral lung lesions are found in as many as 75% of patients with SARS-CoV-2 in a chest computed tomography (CT) scan [1]. The actual extent of COVID-19-related lung involvement may be underestimated In this group of patients, high-resolution computed tomography (HRCT) is the primary diagnostic imaging tool for lung assessment. HRCT is the gold standard in diagnostic imaging of pulmonary interstitial involvement; it requires a patient to be transported to the radiology unit and is associated with exposure to ionizing radiation These disadvantages, as well as the patient’s often dynamically changing clinical status, justify searching for noninvasive methods, alternative or complementary to HRCT, facilitating multiple lung evaluations in hospitalized COVID-19 patients. Lung ultrasound (LUS) appears to be a promising tool in this respect The significance of this modality in detecting interstitial pneumonia of various etiologies has increased recently, and since the onset of the COVID-19 pandemic, LUS has been more often employed for the evaluation of lung involvement in this group of patients [3,4,5].
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