Utility of lung ultrasound in the management of COVID-19 respiratory infection
Main Article Content
Abstract
In the context of the coronavirus disease 2019 (COVID-19) pandemic, lung ultrasound has emerged as an accurate and reliable alternative for assessment of lung pathology.
The main lung ultrasound findings in COVID-19 patients are interstitial syndrome, irregular and broken aspect of the pleural line, and sub-pleural consolidation. Consolidations are usually a late finding appearing during the second week since symptoms onset.
Translating into the practice, lung ultrasound can improve diagnostic accuracy and contribute with relevant information to the triage of these patients. It can be used as part of the routinely assessment of patients admitted to the medical ward allowing early identification of disease progression. Among patients mechanically ventilated, it is useful evaluating response to prone position and/or recruiting maneuvers. Finally, in all the previous scenarios, lung ultrasound may also detect common complications seen in these patients such as cardiogenic pulmonary edema and pulmonary embolism.
In this review, we have summarized the information available and suggest simple algorithm to incorporate lung ultrasound into the assessment of COVID-19 patients.
Keywords:
ultrasonography, coronavirus infection, lung ultrasound, COVID-19
Article Details
How to Cite
CID SERRA, Ximena et al.
Utility of lung ultrasound in the management of COVID-19 respiratory infection.
Medical Research Archives, [S.l.], v. 8, n. 8, aug. 2020.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2191>. Date accessed: 23 nov. 2024.
doi: https://doi.org/10.18103/mra.v8i8.2191.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
2. Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020.
3. World Heatth Organization. Coronavirus disease 2019 (COVID-19) Situation Report -46. https://wwwwhoint/docs/default-source/coronaviruse/situation-reports/20200306-sitrep-46-covid-19pdf?sfvrsn=96b04adf_4 (20 April 2020).
4. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513.
5. Lin C, Xiang J, Yan M, Li H, Huang S, Shen C. Comparison of throat swabs and sputum specimens for viral nucleic acid detection in 52 cases of novel coronavirus (SARS-Cov-2)-infected pneumonia (COVID-19). Clin Chem Lab Med. 2020.
6. Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for Typical 2019-nCoV Pneumonia: Relationship to Negative RT-PCR Testing. Radiology. 2020:200343.
7. Agarwal PP, Cinti S, Kazerooni EA. Chest radiographic and CT findings in novel swine-origin influenza A (H1N1) virus (S-OIV) infection. AJR Am J Roentgenol. 2009;193(6):1488-1493.
8. Hui JY, Hon TY, Yang MK, et al. High-resolution computed tomography is useful for early diagnosis of severe acute respiratory syndrome-associated coronavirus pneumonia in patients with normal chest radiographs. J Comput Assist Tomogr. 2004;28(1):1-9.
9. Peris A, Tutino L, Zagli G, et al. The use of point-of-care bedside lung ultrasound significantly reduces the number of radiographs and computed tomography scans in critically ill patients. Anesth Analg. 2010;111(3):687-692.
10. Vetrugno L, Bove T, Orso D, et al. Our Italian experience using lung ultrasound for identification, grading and serial follow-up of severity of lung involvement for management of patients with COVID-19. Echocardiography. 2020.
11. Huang Y, Wang S, Liu Y, et al. A preliminary study on the ultrasonic manifestations or peripulmonary lesions of non-critical noverl coronavirus pneumonia (COVID-19). Social Science Research Network (SSRN). 2020.
12. Peng QY, Wang XT, Zhang LN, Chinese Critical Care Ultrasound Study G. Findings of lung ultrasonography of novel corona virus pneumonia during the 2019-2020 epidemic. Intensive care medicine. 2020.
13. Yasukawa K, Minami T. Point-of-Care Lung Ultrasound Findings in Patients with COVID-19 Pneumonia. Am J Trop Med Hyg. 2020;102(6):1198-1202.
14. Poggiali E, Dacrema A, Bastoni D, et al. Can Lung US Help Critical Care Clinicians in the Early Diagnosis of Novel Coronavirus (COVID-19) Pneumonia? Radiology. 2020:200847.
15. Lomoro P, Verde F, Zerboni F, et al. COVID-19 pneumonia manifestations at the admission on chest ultrasound, radiographs, and CT: single-center study and comprehensive radiologic literature review. Eur J Radiol Open. 2020;7:100231.
16. Xing C, Li Q, Du H, Kang W, Lian J, Yuan L. Lung ultrasound findings in patients with COVID-19 pneumonia. Crit Care. 2020;24(174).
17. Lu W, Zhang S, Chen B, et al. A Clinical Study of Noninvasive Assessment of Lung Lesions in Patients with Coronavirus Disease-19 (COVID-19) by Bedside Ultrasound. Ultraschall Med. 2020;41(3):300-307.
18. Chung M, Bernheim A, Mei X, et al. CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology. 2020;295(1):202-207.
19. Guan W, Liu J, Yu C. CT Findings of Coronavirus Disease (COVID-19) Severe Pneumonia. AJR Am J Roentgenol. 2020:W1-W2.
20. Volpicelli G, Gargani L. Sonographic signs and patterns of COVID-19 pneumonia. Ultrasound J. 2020;12(1):22.
21. Volpicelli G, Lamorte A, Villen T. What's new in lung ultrasound during the COVID-19 pandemic. Intensive care medicine. 2020.
22. Fox S, Akmatbekov A, Harbert J, Li G, Brown Q, Vander-Heide R. Pulmonary and cardiac pathology in Covid-19: The first autopsy series from New Orleans. medRxiv preprint doi. 2020.
23. Klok FA, Kruip M, van der Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020.
24. Bernheim A, Mei X, Huang M, et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology. 2020:200463.
25. Pan F, Ye T, Sun P, et al. Time Course of Lung Changes On Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia. Radiology. 2020:200370.
26. Lichtenstein DA. BLUE-protocol and FALLS-protocol: two applications of lung ultrasound in the critically ill. Chest. 2015;147(6):1659-1670.
27. Ford JW, Heiberg J, Brennan AP, et al. A Pilot Assessment of 3 Point-of-Care Strategies for Diagnosis of Perioperative Lung Pathology. Anesth Analg. 2017;124(3):734-742.
28. Zhou Y, Yang GD, Feng K, et al. [Clinical features and chest CT findings of coronavirus disease 2019 in infants and young children]. Zhongguo Dang Dai Er Ke Za Zhi. 2020;22(3):215-220.
29. Driggin E, Madhavan MV, Bikdeli B, et al. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the Coronavirus Disease 2019 (COVID-19) Pandemic. J Am Coll Cardiol. 2020.
30. Gargani L, Soliman-Aboumarie H, Volpicelli G, Corradi F, Pastore MC, Cameli M. Why, when, and how to use lung ultrasound during the COVID-19 pandemic: enthusiasm and caution. Eur Heart J Cardiovasc Imaging. 2020.
31. Soldati G, Smargiassi A, Inchingolo R, et al. Proposal for International Standardization of the Use of Lung Ultrasound for Patients With COVID-19: A Simple, Quantitative, Reproducible Method. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 2020.
32. Bello G, Blanco P. Lung Ultrasonography for Assessing Lung Aeration in Acute Respiratory Distress Syndrome: A Narrative Review. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 2019;38(1):27-37.
33. Wang XT, Ding X, Zhang HM, et al. Lung ultrasound can be used to predict the potential of prone positioning and assess prognosis in patients with acute respiratory distress syndrome. Crit Care. 2016;20(1):385.
34. Del Rey Hurtado de Mendoza B, Sanchez-de-Toledo J, Rodriguez-Fanjul J. Chest ultrasound for guiding lung recruitment maneuvers. Med Intensiva. 2018;42(8):e20.
35. Tusman G, Acosta CM, Bohm SH, et al. Postural lung recruitment assessed by lung ultrasound in mechanically ventilated children. Crit Ultrasound J. 2017;9(1):22.
36. Tenza-Lozano E, Llamas-Alvarez A, Jaimez-Navarro E, Fernandez-Sanchez J. Lung and diaphragm ultrasound as predictors of success in weaning from mechanical ventilation. Crit Ultrasound J. 2018;10(1):12.
37. Gattinoni L, Chiumello D, Caironi P, et al. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive care medicine. 2020;46(6):1099-1102.
38. Denault AY, Delisle S, Canty D, et al. A proposed lung ultrasound and phenotypic algorithm for the care of COVID-19 patients with acute respiratory failure. Can J Anaesth. 2020.
2. Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020.
3. World Heatth Organization. Coronavirus disease 2019 (COVID-19) Situation Report -46. https://wwwwhoint/docs/default-source/coronaviruse/situation-reports/20200306-sitrep-46-covid-19pdf?sfvrsn=96b04adf_4 (20 April 2020).
4. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513.
5. Lin C, Xiang J, Yan M, Li H, Huang S, Shen C. Comparison of throat swabs and sputum specimens for viral nucleic acid detection in 52 cases of novel coronavirus (SARS-Cov-2)-infected pneumonia (COVID-19). Clin Chem Lab Med. 2020.
6. Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for Typical 2019-nCoV Pneumonia: Relationship to Negative RT-PCR Testing. Radiology. 2020:200343.
7. Agarwal PP, Cinti S, Kazerooni EA. Chest radiographic and CT findings in novel swine-origin influenza A (H1N1) virus (S-OIV) infection. AJR Am J Roentgenol. 2009;193(6):1488-1493.
8. Hui JY, Hon TY, Yang MK, et al. High-resolution computed tomography is useful for early diagnosis of severe acute respiratory syndrome-associated coronavirus pneumonia in patients with normal chest radiographs. J Comput Assist Tomogr. 2004;28(1):1-9.
9. Peris A, Tutino L, Zagli G, et al. The use of point-of-care bedside lung ultrasound significantly reduces the number of radiographs and computed tomography scans in critically ill patients. Anesth Analg. 2010;111(3):687-692.
10. Vetrugno L, Bove T, Orso D, et al. Our Italian experience using lung ultrasound for identification, grading and serial follow-up of severity of lung involvement for management of patients with COVID-19. Echocardiography. 2020.
11. Huang Y, Wang S, Liu Y, et al. A preliminary study on the ultrasonic manifestations or peripulmonary lesions of non-critical noverl coronavirus pneumonia (COVID-19). Social Science Research Network (SSRN). 2020.
12. Peng QY, Wang XT, Zhang LN, Chinese Critical Care Ultrasound Study G. Findings of lung ultrasonography of novel corona virus pneumonia during the 2019-2020 epidemic. Intensive care medicine. 2020.
13. Yasukawa K, Minami T. Point-of-Care Lung Ultrasound Findings in Patients with COVID-19 Pneumonia. Am J Trop Med Hyg. 2020;102(6):1198-1202.
14. Poggiali E, Dacrema A, Bastoni D, et al. Can Lung US Help Critical Care Clinicians in the Early Diagnosis of Novel Coronavirus (COVID-19) Pneumonia? Radiology. 2020:200847.
15. Lomoro P, Verde F, Zerboni F, et al. COVID-19 pneumonia manifestations at the admission on chest ultrasound, radiographs, and CT: single-center study and comprehensive radiologic literature review. Eur J Radiol Open. 2020;7:100231.
16. Xing C, Li Q, Du H, Kang W, Lian J, Yuan L. Lung ultrasound findings in patients with COVID-19 pneumonia. Crit Care. 2020;24(174).
17. Lu W, Zhang S, Chen B, et al. A Clinical Study of Noninvasive Assessment of Lung Lesions in Patients with Coronavirus Disease-19 (COVID-19) by Bedside Ultrasound. Ultraschall Med. 2020;41(3):300-307.
18. Chung M, Bernheim A, Mei X, et al. CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology. 2020;295(1):202-207.
19. Guan W, Liu J, Yu C. CT Findings of Coronavirus Disease (COVID-19) Severe Pneumonia. AJR Am J Roentgenol. 2020:W1-W2.
20. Volpicelli G, Gargani L. Sonographic signs and patterns of COVID-19 pneumonia. Ultrasound J. 2020;12(1):22.
21. Volpicelli G, Lamorte A, Villen T. What's new in lung ultrasound during the COVID-19 pandemic. Intensive care medicine. 2020.
22. Fox S, Akmatbekov A, Harbert J, Li G, Brown Q, Vander-Heide R. Pulmonary and cardiac pathology in Covid-19: The first autopsy series from New Orleans. medRxiv preprint doi. 2020.
23. Klok FA, Kruip M, van der Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020.
24. Bernheim A, Mei X, Huang M, et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology. 2020:200463.
25. Pan F, Ye T, Sun P, et al. Time Course of Lung Changes On Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia. Radiology. 2020:200370.
26. Lichtenstein DA. BLUE-protocol and FALLS-protocol: two applications of lung ultrasound in the critically ill. Chest. 2015;147(6):1659-1670.
27. Ford JW, Heiberg J, Brennan AP, et al. A Pilot Assessment of 3 Point-of-Care Strategies for Diagnosis of Perioperative Lung Pathology. Anesth Analg. 2017;124(3):734-742.
28. Zhou Y, Yang GD, Feng K, et al. [Clinical features and chest CT findings of coronavirus disease 2019 in infants and young children]. Zhongguo Dang Dai Er Ke Za Zhi. 2020;22(3):215-220.
29. Driggin E, Madhavan MV, Bikdeli B, et al. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the Coronavirus Disease 2019 (COVID-19) Pandemic. J Am Coll Cardiol. 2020.
30. Gargani L, Soliman-Aboumarie H, Volpicelli G, Corradi F, Pastore MC, Cameli M. Why, when, and how to use lung ultrasound during the COVID-19 pandemic: enthusiasm and caution. Eur Heart J Cardiovasc Imaging. 2020.
31. Soldati G, Smargiassi A, Inchingolo R, et al. Proposal for International Standardization of the Use of Lung Ultrasound for Patients With COVID-19: A Simple, Quantitative, Reproducible Method. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 2020.
32. Bello G, Blanco P. Lung Ultrasonography for Assessing Lung Aeration in Acute Respiratory Distress Syndrome: A Narrative Review. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 2019;38(1):27-37.
33. Wang XT, Ding X, Zhang HM, et al. Lung ultrasound can be used to predict the potential of prone positioning and assess prognosis in patients with acute respiratory distress syndrome. Crit Care. 2016;20(1):385.
34. Del Rey Hurtado de Mendoza B, Sanchez-de-Toledo J, Rodriguez-Fanjul J. Chest ultrasound for guiding lung recruitment maneuvers. Med Intensiva. 2018;42(8):e20.
35. Tusman G, Acosta CM, Bohm SH, et al. Postural lung recruitment assessed by lung ultrasound in mechanically ventilated children. Crit Ultrasound J. 2017;9(1):22.
36. Tenza-Lozano E, Llamas-Alvarez A, Jaimez-Navarro E, Fernandez-Sanchez J. Lung and diaphragm ultrasound as predictors of success in weaning from mechanical ventilation. Crit Ultrasound J. 2018;10(1):12.
37. Gattinoni L, Chiumello D, Caironi P, et al. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive care medicine. 2020;46(6):1099-1102.
38. Denault AY, Delisle S, Canty D, et al. A proposed lung ultrasound and phenotypic algorithm for the care of COVID-19 patients with acute respiratory failure. Can J Anaesth. 2020.