Changes in lung ultrasound of symptomatic healthcare professionals with COVID-19 pneumonia and their association with clinical findings

J Clin Ultrasound. 2020 Nov;48(9):515-521. doi: 10.1002/jcu.22905. Epub 2020 Aug 21.

Abstract

Purpose: To evaluate ultrasound signs of coronavirus disease-19 (COVID-19) pneumonia in symptomatic healthcare professionals and to correlate those changes with clinical findings.

Methods: All patients underwent real-time polymerase chain reaction (RT-PCR), lung ultrasound (LUS) and clinical evaluation on the same day. In each of the 12 areas evaluated in the LUS, the LUS signs were scored to generate the aeration score.

Results: A total of 409 participants had positive PCR, with a median age of 41 (35-51) years. All participants had clinical symptoms, with cough in 84.1%, fever in 69.7%, and dyspnea in 36.2% of cases. In the LUS, 72.6% of participants had B-lines >2, 36.2% had coalescent B-lines, and 8.06% had subpleural consolidations. The median aeration score was 3 (2-7). The aeration score differed significantly regarding the presence of cough (P = .002), fever (P = .001), and dyspnea (P < .0001). The finding of subpleural consolidations in the LUS showed significant differences between participants with or without dyspnea (P < .0001).

Conclusions: In healthcare professionals with COVID-19, LUS plays a key role in the characterization of lung involvement. Although B-lines are the most common ultrasound sign, subpleural consolidations are those that most impact the respiratory condition.

Keywords: COVID-19; dyspnea; lung ultrasound; novel coronavirus; pneumonia.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Betacoronavirus / genetics
  • Betacoronavirus / isolation & purification
  • COVID-19
  • COVID-19 Testing
  • COVID-19 Vaccines
  • Clinical Laboratory Techniques / methods
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / diagnostic imaging*
  • Coronavirus Infections / pathology
  • Coronavirus Infections / virology
  • Cross-Sectional Studies
  • Female
  • Health Personnel*
  • Humans
  • Lung / diagnostic imaging*
  • Lung / pathology
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / diagnostic imaging*
  • Pneumonia, Viral / pathology
  • Pneumonia, Viral / virology
  • Real-Time Polymerase Chain Reaction
  • SARS-CoV-2
  • Ultrasonography / methods