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Lung Ultrasound in COVID-19 Pneumonia: Correlations with Chest CT on Hospital admission

Authors
  • Nouvenne, Antonio
  • Zani, Marco Davìd
  • Milanese, Gianluca
  • Parise, Alberto
  • Baciarello, Marco
  • Bignami, Elena Giovanna
  • Odone, Anna
  • Sverzellati, Nicola
  • Meschi, Tiziana
  • Ticinesi, Andrea
Type
Published Article
Journal
Respiration
Publisher
S. Karger AG
Publication Date
Jun 22, 2020
Volume
99
Issue
7
Pages
617–624
Identifiers
DOI: 10.1159/000509223
PMID: 32570265
Source
Karger
Keywords
License
Green
External links

Abstract

Background: Lung ultrasound (LUS) is an accurate, safe, and cheap tool assisting in the diagnosis of several acute respiratory diseases. The diagnostic value of LUS in the workup of coronavirus disease-19 (COVID-19) in the hospital setting is still uncertain. Objectives: The aim of this observational study was to explore correlations of the LUS appearance of COVID-19-related pneumonia with CT findings. Methods: Twenty-six patients (14 males, age 64 ± 16 years) urgently hospitalized for COVID-19 pneumonia, who underwent chest CT and bedside LUS on the day of admission, were enrolled in this observational study. CT images were reviewed by expert chest radiologists, who calculated a visual CT score based on extension and distribution of ground-glass opacities and consolidations. LUS was performed by clinicians with certified competency in thoracic ultrasonography, blind to CT findings, following a systematic approach recommended by ultrasound guidelines. LUS score was calculated according to presence, distribution, and severity of abnormalities. Results: All participants had CT findings suggestive of bilateral COVID-19 pneumonia, with an average visual scoring of 43 ± 24%. LUS identified 4 different possible ­abnormalities, with bilateral distribution (average LUS score 15 ± 5): focal areas of nonconfluent B lines, diffuse confluent B lines, small subpleural microconsolidations with pleural line irregularities, and large parenchymal consolidations with air bronchograms. LUS score was significantly correlated with CT visual scoring (r = 0.65, p < 0.001) and oxygen saturation in room air (r = –0.66, p < 0.001). Conclusion: When integrated with clinical data, LUS could represent a valid diagnostic aid in patients with suspect COVID-19 pneumonia, which reflects CT findings.

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