Lung Ultrasound Findings in a Covid-19 Patient with Negative Chest CT

Abstract Background Lung ultrasound can adequately monitor disease severity in pneumonia and acute respiratory distress syndrome. We hypothesize lung ultrasound can adequately monitor COVID-19 pneumonia in critically ill patients. Methods Adult patients with COVID-19 pneumonia admitted to the intensive care unit of two academic hospitals who underwent a 12-zone lung ultrasound and a chest CT examination were included. Baseline characteristics, and outcomes including composite endpoint death or ICU stay > 30 days were recorded. Lung ultrasound and CT images were quantified as a lung ultrasound score involvement index (LUSI) and CT severity involvement index (CTSI). Primary outcome was the correlation, agreement, and concordance between LUSI and CTSI. Secondary outcome was the association of LUSI and CTSI with the composite endpoints. Results We included 55 ultrasound examinations in 34 patients, which were 88% were male, with a mean age of 63 years and mean P/F ratio of 151. The correlation between LUSI and CTSI was strong (r = 0.795), with an overall 15% bias, and limits of agreement ranging − 40 to 9.7. Concordance between changes in sequentially measured LUSI and CTSI was 81%. In the univariate model, high involvement on LUSI and CTSI were associated with a composite endpoint. In the multivariate model, LUSI was the only remaining independent predictor. Conclusions Lung ultrasound can be used as an alternative for chest CT in monitoring COVID-19 pneumonia in critically ill patients as it can quantify pulmonary involvement, register changes over the course of the disease, and predict death or ICU stay > 30 days. Trial registration: NTR, NL8584. Registered 01 May 2020—retrospectively registered, https://www.trialregister.nl/trial/8584

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Comparison of lung bedside ultrasound and BNP in the diagnosis of acute heart failure in the emergency department

Journal of Research in Clinical Medicine ◽

10.34172/jrcm.2020.050 ◽

2020 ◽

Vol 8 (1) ◽

pp. 50-50

Author(s):

Seyed Hossein Ojaghi Haghighi ◽

Neda Hamed ◽

Shiva Ebrahimi ◽

Jafar Ghobadi ◽

Hoorolnesa Ameli

Keyword(s):

Heart Failure ◽

Emergency Room ◽

Pulmonary Edema ◽

Acute Heart Failure ◽

Lung Ultrasound ◽

P Value ◽

Ultrasound Evaluation ◽

Ultrasound Findings ◽

Medical Advances ◽

B Lines

Introduction: Congestive heart failure is heart muscle failure that causes pulmonary congestion and eventually pulmonary edema, which despite recent medical advances, is still a progressive syndrome with high mortality, the prevalence of which has increased in recent decades. Therefore, in this study we compared lung ultrasound findings in acute heart failure patients with the BNP. Methods: This study was performed in the emergency room of Imam Reza hospital in Tabriz. For patients entering the emergency room after taking a history, both standard gold (BNP) tests and beside ultrasound of the lung were performed. Ultrasound was performed at the same time as obtaining blood sample to ensure that the ultrasound specialist did not know the result of diagnosis. During the ultrasound, if there were multiple B-Lines that were at least 3 mm apart, patient was diagnosed with pulmonary edema due to heart failure. Results: Number of participants in this study was 108 people, 54.6% of whom were men and the rest were women. The correlation coefficient between width and number of kerley lines was 0.79, between NT-pro BNP and width of kerley lines was 0.65 and between NT-pro BNP and number of kerley lines was 0.77, which indicates a significant positive correlation (P value <0.001). Conclusion: The results of present study showed that in patients with acute heart failure, the number and width of kerley lines in pulmonary ultrasound evaluation increase rapidly. There is also a high correlation between number and length of kerley lines with NT-pro BNP serum values.

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Association between lung ultrasound findings and invasive exercise haemodynamics in patients with undifferentiated dyspnoea

ESC Heart Failure ◽

10.1002/ehf2.12381 ◽

2018 ◽

Vol 6 (1) ◽

pp. 202-207 ◽

Cited By ~ 4

Author(s):

Elke Platz ◽

Allison Merz ◽

Montane Silverman ◽

Eldrin Lewis ◽

John D. Groarke ◽

...

Keyword(s):

Lung Ultrasound ◽

Ultrasound Findings

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2019 Novel Coronavirus (COVID-19) pneumonia: an unusual lung ultrasound presentation.

10.21203/rs.3.rs-25490/v1 ◽

2020 ◽

Author(s):

Letizia Consoli ◽

Vittorio Bendotti ◽

Sara Cicchinelli ◽

Federico Gaioni ◽

Paola Prandolini ◽

...

Keyword(s):

Case Fatality Rate ◽

Lung Ultrasound ◽

Case Fatality ◽

Ground Glass Opacity ◽

Public Health Emergency ◽

Fatality Rate ◽

Chest Computed Tomography ◽

Ultrasound Findings ◽

The World ◽

Novel Coronavirus

Abstract In December 2019, a novel coronavirus (SARS-Cov-2) was first reported in Wuhan, China, and rapidly spread around the world, leading to an international emerging public health emergency. As reported from Chinese experiences, approximately 20% of patients had a severe course, requiring intensive care, with an overall case fatality rate of 2.3%. In diagnosis, chest computed tomography most commonly showed ground-glass opacity with or without consolidative patterns.Herein we report a case of a patient affected by COVID-19 pneumonia referred in the emergency department of our institution on 4 April 2020 with peculiar lung ultrasound findings.

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The Role of Lung Ultrasound Before and During the COVID-19 Pandemic: A review article

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666211006122842 ◽

2021 ◽

Vol 17 ◽

Author(s):

Mustafa J. Musa ◽

Mohamed Yousef ◽

Mohammed Adam ◽

Awadalla Wagealla ◽

Lubna Boshara ◽

...

Keyword(s):

Lung Ultrasound ◽

Point Of Care ◽

Power Doppler ◽

Doppler Imaging ◽

Point Of Care Ultrasound ◽

Institute Of Medicine ◽

Pubmed Central ◽

Contrast Enhanced ◽

Ultrasound Findings

: Lung ultrasound [LUS] has evolved considerably over the last years. The aim of the current review is to conduct a systematic review reported from a number of studies to show the usefulness of [LUS] and point of care ultrasound for diagnosing COVID-19. A systematic search of electronic data was conducted including the national library of medicine, and the national institute of medicine, PubMed Central [PMC] to identify the articles depended on [LUS] to monitor COVID-19. This review highlights the ultrasound findings reported in articles before the pandemic [11], clinical articles before COVID-19 [14], review studies during the pandemic [27], clinical cases during the pandemic [5] and other varying aims articles. The reviewed studies revealed that ultrasound findings can be used to help in the detection and staging of the disease. The common patterns observed included irregular and thickened A-lines, multiple B-lines ranging from focal to diffuse interstitial consolidation, and pleural effusion. Sub-plural consolidation is found to be associated with the progression of the disease and its complications. Pneumothorax was not recorded for COVID-19 patients. Further improvement in the diagnostic performance of [LUS] for COVID-19 patients can be achieved by using elastography, contrast-enhanced ultrasound, and power Doppler imaging.

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Lung Ultrasound Findings Associated With COVID-19 ARDS, ICU Admission, and All-Cause Mortality

Respiratory Care ◽

10.4187/respcare.09108 ◽

2021 ◽

pp. respcare.09108

Author(s):

Caroline Espersen ◽

Elke Platz ◽

Kristoffer Grundtvig Skaarup ◽

Mats Christian Højbjerg Lassen ◽

Jannie Nørgaard Lind ◽

...

Keyword(s):

Lung Ultrasound ◽

Icu Admission ◽

Ultrasound Findings ◽

All Cause Mortality

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Lung Ultrasound Findings Compared to Chest CT Scan in Patients with COVID-19 Associated Pneumonia: A Pilot Study

Frontiers in Emergency Medicine ◽

10.18502/fem.v5i2.5612 ◽

2021 ◽

Author(s):

Hamidreza Hatamabadi ◽

Majid Shojaee ◽

Mohammad Bagheri ◽

Masoomeh Raoufi

Keyword(s):

Pilot Study ◽

Ct Scan ◽

Sensitivity And Specificity ◽

Lung Ultrasound ◽

Demographic Data ◽

Ground Glass Opacity ◽

Chest Ct ◽

Clinical Value ◽

Ultrasound Evaluation ◽

Chest Ct Scan

Introduction: Lung US has been reported to be as useful as a chest CT scan and much better than a chest x-ray for the evaluation of pneumonia. Objective: This study aimed to compare the findings of lung ultrasound (US) and chest CT scan of patients with COVID-19-associated pneumonia in the Emergency Department (ED). Methods: This retrospective observational pilot study was carried out on confirmed COVID-19 patients in the isolation corona ward of the Imam Hussein Hospital ED from March 15 to March 22, 2020. After obtaining demographic data, the patients underwent a pulmonary bedside US examination, with the patients in the sitting position, turning their back to the examiner. A 10-point lung US was performed. Each lung was divided into two areas: posterior (three zones) and lateral (two zones). The patients’ lung ultrasound and chest CT scan as the standard imaging were blindly reviewed and recorded. The clinical value of ultrasound was evaluated with different severity of lung involvement according to CT severity score. Results: Nineteen patients (38 zones), including 13 males, were evaluated with a mean age of 62.5±16.8 years. B2 lines and consolidation observed in the US examinations were significantly correlated with ground-glass opacity and consolidation observed in CT scan examinations, respectively (p <0.0001). US sensitivity and specificity of finding B2 lines were 90% and 100%, respectively. Also, the sensitivity and specificity of US in identifying consolidation were 82% and 100%, respectively. In the lungs with moderate and severe lobar involvement, US findings were significantly correlated (p <0.05) with CT scan findings. Conclusions: Ultrasound evaluation is a safe, fast, and rapid technique for the evaluation of patients with moderate to severe COVID-19-associated pneumonia. It is a reproducible procedure and can be implemented by the operator after a short course of training.

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Use of lung ultrasound for diagnosis and monitoring of coronavirus disease 2019 pneumonia: A case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x20958915 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2095891

Author(s):

Debo Yun ◽

Yan Cui ◽

Yuan Geng ◽

Yujiao Yang

Keyword(s):

Case Report ◽

Severe Acute Respiratory Syndrome ◽

Early Diagnosis ◽

Lung Ultrasound ◽

Nasopharyngeal Swab ◽

Ultrasound Images ◽

Healthcare Settings ◽

Pleural Line ◽

Ultrasound Findings ◽

Spread Of Infection

Knowledge of lung ultrasound characteristics of coronavirus disease 2019 pneumonia might be useful for early diagnosis and clinical monitoring of patients, and lung ultrasound can help to control the spread of infection in healthcare settings. In this case report, a 36-year-old man with severe acute respiratory syndrome coronavirus 2 infection was diagnosed by reverse transcription-polymerase chain reaction testing of a nasopharyngeal swab. The lung ultrasound findings for this patient were the interstitial-alveolar damage showing bilateral, diffuse pleural line abnormalities, subpleural consolidations, white lung areas and thick, irregular vertical artifacts. When the patient recovered from the severe acute respiratory syndrome coronavirus 2 infection, lung ultrasound images showed a normal pleural line with A-lines regularly reverberating. Performing lung ultrasound at the bedside minimizes the need to move the patient, thus reducing the risk of spreading infection among healthcare staff. Lung ultrasound is useful for early diagnosis and evaluation of the severity of coronavirus disease 2019 pneumonia and for monitoring its progress over the course of the disease.

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