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

Respiration. 2020;99(7):617-624. doi: 10.1159/000509223. Epub 2020 Jun 22.

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.

Keywords: Chest ultrasound; Coronavirus pneumonia; Point-of-care ultrasonography; SARS-CoV-2; Thoracic ultrasound.

Publication types

  • Observational Study

MeSH terms

  • Betacoronavirus / isolation & purification*
  • COVID-19
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / physiopathology
  • Correlation of Data
  • Diagnostic Tests, Routine / methods
  • Female
  • Humans
  • Italy / epidemiology
  • Lung / diagnostic imaging*
  • Male
  • Middle Aged
  • Pandemics*
  • Pneumonia, Viral* / diagnosis
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / etiology
  • Pneumonia, Viral* / physiopathology
  • Point-of-Care Testing
  • Reproducibility of Results
  • SARS-CoV-2
  • Tomography, X-Ray Computed / methods*
  • Ultrasonography / methods*