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

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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Case Report: Case report: Pulmonary hemorrhage as a rare cause of lung ultrasound A/B-profile

F1000Research ◽

10.12688/f1000research.19329.1 ◽

2019 ◽

Vol 8 ◽

pp. 788

Author(s):

Mark E. Haaksma ◽

Esther J. Nossent ◽

Paul Elbers ◽

Pieter Roel Tuinman

Keyword(s):

Risk Factors ◽

Case Report ◽

Respiratory Failure ◽

Acute Respiratory Failure ◽

Lung Ultrasound ◽

Clinical Signs ◽

Pulmonary Hemorrhage ◽

Final Diagnosis ◽

Ultrasound Findings ◽

Patient’S History

When using lung ultrasound to determine the cause of acute respiratory failure, the BLUE protocol is often used. In a 65-year old patient, an A/B-profile was found, suggesting pneumonia, following the flowchart of this protocol. In this case, however, pulmonary hemorrhage confirmed by bronchoscopy was the final diagnosis. This case report outlines the importance of understanding the limitations of the BLUE protocol and that lung ultrasound findings should always be used in the context of the patient’s history and physical exam. In addition, pulmonary hemorrhage should be considered in patients with no clinical signs of pneumonia and/or presence of risk factors for lung bleeding as a rare cause of lung ultrasound A/B-profile.

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Exploring the Conditions of Atelectasis in General Anesthesia Patients at Different Time Nodes and Different Chest Areas by Ultrasound Images

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2021.3326 ◽

2021 ◽

Vol 11 (2) ◽

pp. 601-605

Author(s):

Yu Tang ◽

Yanchao Yang ◽

Yannis Oannidis ◽

Kathe Rin

Keyword(s):

General Anesthesia ◽

Lung Ultrasound ◽

Lung Ventilation ◽

Normal Lung ◽

Ultrasound Images ◽

Pleural Line ◽

Left Posterior ◽

Research Objects ◽

Posterior Area ◽

Lateral Area

Objective: To find a more convenient and effective method for monitoring the conditions and changes of atelectasis, the Lung Ultrasound (LUS) scores of general anesthesia patients at different time nodes and different chest areas were evaluated under ultrasound images to determine the conditions of atelectasis of the patients. Methods: Patients who underwent general anesthesia were included as research objects. After general anesthesia, LUS was performed on 12 different chest areas of patients respectively on 1 day preoperatively (T1), 30 minutes (min) after extubation of general anesthesia (T2), 24 hours (h) postoperatively (T3), and 48 h postoperatively (T4). The LUS scores were recorded and compared. Results: Among the lung ultrasound images of the classic case, at T1, the patient was in normal lung ventilation; at T2, the pleural line of patient was intermittently irregular, indicating a decrease in lung ventilation; at T3, a small consolidation plaque was seen under the pleural line; at T4, the consolidation continued to develop, and the decrease in lung ventilation was aggravated. The total scores of T2 were significantly higher than those of T1 (P < 0.05), while the total scores of T2, T3, and T4 were not significantly different (P > 0.05). The LUS scores of all chest areas at T2, T3, and T4 were significantly higher than those at T1 (P < 0.05), in which the increase in the LUS scores of lower left lateral area, left Posterolateral Alveolar and/or Pleural Syndrome (PLAPS) area, lower left posterior area, lower right lateral area, right PLAPS area, and lower right posterior area were particularly significant. Conclusion: The lung ultrasound images of general anesthesia patients suggested the onset of atelectasis, which could last up to 24 h postoperatively. The most severe areas of atelectasis included the lower lateral areas, the PLAPS areas, and the lower posterior areas.

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Role of lung ultrasound in identifying COVID-19 pneumonia in patients with negative swab during the outbreak

Emergency Care Journal ◽

10.4081/ecj.2020.9026 ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

Giuseppe Aiosa ◽

Romina Gianfreda ◽

Marco Pastorino ◽

Piero Davio

Keyword(s):

Internal Medicine ◽

Lung Ultrasound ◽

False Negative ◽

Nasopharyngeal Swab ◽

Internal Medicine Ward ◽

X Ray ◽

Ultrasound Findings ◽

Chest X Ray ◽

Critical Patients

Lung ultrasound is a reasonable tool for detection of manifestations of COVID-19, to facilitate the division of patients flow of infected with SARS-CoV-2 from those affected by other pathologies. Often, a reason for the incorrect separation of the flows is the possibility of false-negative rRT-PCR results. We aimed to evaluate the advantages of performing Lung Ultrasound (LUS) in patients with a negative swab, to confirm the suspicious of COVID-19 at the bedside, according to the recent findings of typical lung ultrasound lesions of COVID19 related pneumonia. We analyzed 11 non-critical patients admitted to Emergency Department in the Internal Medicine ward, during outbreak, as Covid-19 negative patients affected by pneumonia. The result of the ultrasound findings conditioned the consequent allocation of the patient. 9/11 patients had typical LUS findings for COVID-19, but only 3/11 patients had a second positive nasopharyngeal swab, and 2/11 had positive swab on pleural fluid. 6/11 patients remained negative with strongly suspicious LUS lesions, and so treated and isolated as Covid-19 positive. 2/11 had negative swab and none LUS findings, thus treated as affected by other pathologies. These findings clearly show how LUS plays an important role together with the chest x-ray in identifying patients with interstitial pneumonia from COVID-19.

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Quantitative Analysis of Pleural Line and B-lines in Lung Ultrasound Images for Severity Assessment of COVID-19 Pneumonia

IEEE Transactions on Ultrasonics Ferroelectrics and Frequency Control ◽

10.1109/tuffc.2021.3107598 ◽

2021 ◽

pp. 1-1

Author(s):

Yuanyuan Wang ◽

Yao Zhang ◽

Qiong He ◽

Hongen Liao ◽

Jianwen Luo

Keyword(s):

Quantitative Analysis ◽

Lung Ultrasound ◽

Ultrasound Images ◽

Severity Assessment ◽

Pleural Line ◽

B Lines

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Lung ultrasound findings in patients with novel SARS-CoV2

10.1101/2020.05.18.20105775 ◽

2020 ◽

Cited By ~ 1

Author(s):

Mark Evert Haaksma ◽

Micah L.A. Heldeweg ◽

Jorge E. Lopez Matta ◽

Jasper Martijn Smit ◽

Jessica D. van Trigt ◽

...

Keyword(s):

Pleural Effusion ◽

Lung Ultrasound ◽

Dynamic Compliance ◽

Clinical Parameters ◽

Duration Of Symptoms ◽

Pleural Line ◽

Long Duration ◽

Academic Hospitals ◽

Ultrasound Findings ◽

Lung Sliding

Background: Over 2 million people worldwide have been infected with Severe Acute Respiratory Distress Syndrome Corona Virus 2 (SARS CoV2). Lung ultrasound has been proposed to diagnose and it. However, little is known about ultrasound findings in these patients. Our aim is to present an overview of lung ultrasound characteristics in critically ill patients with SARS CoV2 pneumonia overall and in relation to the duration of symptoms and clinical parameters. Methods: On the Intensive Care Unit of two academic hospitals, adult patients who tested positive for SARS-CoV2 were included. Images were analyzed for pleural line characteristics, number and appearance of B-lines, BLUE-profiles (Bedside Lung Ultrasound in Emergency), pathology in the PLAPS (Postero Lateral Alveolar and Pleural Syndrome) point and a LUS-score (lung ultrasound). The primary outcomes were frequencies, percentages and differences in lung ultrasound findings overall and between short (≤14 days) and long (>14 days) duration of symptoms and their correlation with clinical parameters. Results: In this pilot observational study, 61 patients were included with 75 examinations for analysis. The most prevalent ultrasound findings were decreased lung sliding (36%), thickening of the pleural line (42%) and a C-profile per view (37%). Patients with ″long″ duration of symptoms presented more frequently with a thickened and irregular pleural line (21% (32) vs 9% (11), p=.01), C-profile per patient (47% (18) vs. 25% (8),p=.01) and pleural effusion (19% (14) vs 5% (3),p=.02) compared to patients with short duration of symptoms. Lung ultrasound findings did not correlate with P/F ratio, fluid balance or dynamic compliance, with the exception of the LUS-score and dynamic compliance (R2=0.27, p=.02). Conclusion: SARS CoV2 results in significant ultrasound changes, with decreased lung sliding, thickening of the pleural line and a C-profile being the most observed. With time, a thickened and irregular pleural line, C-profile and pleural effusion become more common findings.

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Lung ultrasound and neonatal COVID-19 pneumonia: A case report.

10.21203/rs.3.rs-33182/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Daniel Ibarra Ríos ◽

Dina Villanueva García ◽

Edna Patricia Vázquez Solano ◽

Alfonso de Jesús Martínez García ◽

Horacio Márquez González

Keyword(s):

Mechanical Ventilation ◽

Pulmonary Hypertension ◽

Case Report ◽

Respiratory Tract ◽

Lung Ultrasound ◽

Male Infant ◽

Pleural Line ◽

Novel Coronavirus ◽

B Lines

Abstract Purpose: Severe Novel Coronavirus Disease 2019 (COVID-19) infection in neonates is possible but reports are scarce. Lung ultrasound (LUS) has been reported useful for triaging, diagnosing, and monitoring of patients with COVID-19.Material and methods: We describe SARS-CoV-2 confirmed infection on a term newborn that developed pneumonia and pulmonary hypertension requiring mechanical ventilation. Ultrasonographic follow up of COVID-19 pneumonia and pulmonary hypertension was carried out. Results: A 3,140-g male infant born at 40.3 weeks’ gestation developed progressive respiratory distress requiring mechanical ventilation. Real time PCR respiratory tract swabs for SARS COV 2 sampled on day 3 were positive for the baby and both parents. Lung ultrasound showed an irregular pleural line (shred sign), multiple confluent B-lines and bilateral ≥ 0.5 cm subpleural consolidations. Improvement of the lung and cardiac conditions were documented by ultrasound. Conclusion: Our case represents a severe presentation of COVID-19 pneumonia with pulmonary hypertension requiring mechanical ventilation. LUS showed to be useful for diagnosis and follow up.

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Case Report: Pulmonary hemorrhage as a rare cause of lung ultrasound A/B-profile

F1000Research ◽

10.12688/f1000research.19329.2 ◽

2019 ◽

Vol 8 ◽

pp. 788

Author(s):

Mark E. Haaksma ◽

Esther J. Nossent ◽

Paul Elbers ◽

Pieter Roel Tuinman

Keyword(s):

Risk Factors ◽

Case Report ◽

Respiratory Failure ◽

Acute Respiratory Failure ◽

Lung Ultrasound ◽

Clinical Signs ◽

Pulmonary Hemorrhage ◽

Final Diagnosis ◽

Ultrasound Findings ◽

Patient’S History

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Case Report: Detection of SARS-CoV-2 From Cerebrospinal Fluid in a 34-Month-Old Child With Encephalitis

Frontiers in Pediatrics ◽

10.3389/fped.2021.565778 ◽

2021 ◽

Vol 9 ◽

Author(s):

Fatemeh Cheraghali ◽

Alireza Tahamtan ◽

Seyed Ahmad Hosseini ◽

Mohammad Hadi Gharib ◽

Abdolvahab Moradi ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Case Report ◽

Severe Acute Respiratory Syndrome ◽

Nasopharyngeal Swab ◽

Neurological Manifestations ◽

Novel Coronavirus

Novel coronavirus (severe acute respiratory syndrome-coronavirus-2: SARS-CoV-2), which arose from Wuhan, China, has rapidly spread to other countries and developed into a pandemic. Although the respiratory manifestations of SARS-CoV-2 are well-documented, there is a considerable challenge regarding the direct and/or indirect infection in other organs. Several preliminary reports confirmed neurological manifestations in the SARS-CoV-2-infected patients. Here, we report the detection of SARS-CoV-2 from the nasopharyngeal swab and cerebrospinal fluid (CSF) in a 34-month-old child with encephalitis. This finding expands the spectrum of the neurological manifestations associated with SARS-CoV-2 infection.

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Use of lung ultrasound in neonates during the COVID-19 pandemic

Radiologia Brasileira ◽

10.1590/0100-3984.2020.0110 ◽

2020 ◽

Vol 53 (6) ◽

pp. 401-404

Author(s):

Marcia Wang Matsuoka ◽

Silvia Maria Sucena da Rocha ◽

Maria Augusta Bento Cicaroni Gibelli ◽

Carla Marques Nicolau ◽

Werther Brunow de Carvalho ◽

...

Keyword(s):

Respiratory Symptoms ◽

Distress Syndrome ◽

Lung Ultrasound ◽

Ultrasound Examination ◽

Neonatal Period ◽

Ultrasound Images ◽

Normal Pattern ◽

Pleural Thickening ◽

Pleural Line ◽

B Lines

Abstract In the current pandemic, caused by infection with severe acute respiratory syndrome coronavirus 2, ultrasound has played a fundamental role in patients who develop the resulting disease, designated coronavirus disease 2019 (COVID-19). In this study we present ultrasound images of the lungs of neonates with a suspected or confirmed diagnosis of COVID-19, distinguishing between the changes related to COVID-19 and those unrelated to the disease. Ultrasound examinations were performed by a pediatric sonographer. A total of 27 neonates were evaluated. Among those who presented no respiratory symptoms, some tested negative for COVID-19 and others tested positive. All of those who were pulmonary symptomatic, negative for COVID-19 presented transient tachypnea of the newborn and respiratory distress syndrome. Lung ultrasound images obtained in COVID-19-negative neonates showed, in some cases, a normal pattern (with A lines, few B lines, a thin, linear pleural line, and no pleural effusion), whereas in others showed coalescent B lines and areas of opacity. In two of the COVID-19-positive neonates, lung ultrasound examination showed several coalescent B lines, pleural thickening, and areas of opacity. Lung ultrasound in the neonatal period appears to be applicable within the context of the current pandemic, allowing efficient evaluation of COVID-19-related changes in neonates, as well as of pathologies inherent to the neonatal period.

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