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

2020; Karger Publishers; Volume: 99; Issue: 7 Linguagem: Inglês

10.1159/000509223

1423-0356

Antonio Nouvenne, Marco Davìd Zani, Gianluca Milanese, Alberto Parise, Marco Baciarello, Elena Bignami, Anna Odone, Nicola Sverzellati, Tiziana Meschi, Andrea Ticinesi,

Pleural and Pulmonary Diseases

<b><i>Background:</i></b> 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. <b><i>Objectives:</i></b> The aim of this observational study was to explore correlations of the LUS appearance of COVID-19-related pneumonia with CT findings. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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 (<i>r</i> = 0.65, <i>p</i> &#x3c; 0.001) and oxygen saturation in room air (<i>r</i> = –0.66, <i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> When integrated with clinical data, LUS could represent a valid diagnostic aid in patients with suspect COVID-19 pneumonia, which reflects CT findings.