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Respir Care
. 2021 Mar 23;respcare.08382.
doi: 10.4187/respcare.08382. Online ahead of print.
Value of Bedside Lung Ultrasound in Severe and Critical COVID-19 Pneumonia
Shuangshuang Kong 1 2 , Jing Wang 1 2 , Yuman Li 1 2 , Ying Tian 1 2 , Cheng Yu 1 2 , Danqing Zhang 1 2 , Hong Li 1 2 , Li Zhang 1 2 , Xueqin Pang 1 2 , Mingxing Xie 3 2
Affiliations
- PMID: 33758057
- DOI: 10.4187/respcare.08382
Abstract
Background: Lung ultrasound (LUS) is an effective imaging modality that can differentiate pathological lung from non-diseased lung. We aimed to explore the value of bedside LUS in patients with severe and critical coronavirus disease 2019 (COVID-19)-associated lung injury.
Methods: Sixty-three severe and 33 critical hospitalized subjects with COVID-19 were enrolled in this study. Bedside LUS was performed in all subjects; chest computed tomography was performed on the same day as bedside LUS in 23 cases. The LUS protocol consisted of 12 scanning zones. LUS score based on B-lines and lung consolidation was evaluated.
Results: The most common abnormality of LUS was the various forms of B-lines, detected in 93 (96.9%) subjects; as the second most frequent abnormality, 80 (83.3%) subjects exhibited lung consolidation, mainly located in the posterior lung region. Twenty-four (25.0%) subjects had pleural line abnormalities, and 16 (16.7%) had pleural effusion; 78 (81.3%) subjects had ? 2 abnormal LUS patterns, and 93 (96.9%) had bilateral lung involvement. The proportion of bilateral or unilateral lung consolidation and pleural effusion in the critical COVID-19 group were higher than that in the severe group (P < .05). The lung consolidation of critical subjects showed a marked increase in most lung areas, including bilateral lateral lung, posterior lung, and left anterior-inferior lung area. The median (interquartile range) LUS scores of critical cases were higher than those of severe cases: left: 14 (12-17) vs 7 (5-12); right: 14 (10-16) vs 8 (3-12); bilateral: 28 (23-31) vs 15 (8-22) (P < .001 for all). There was a good correlation between the LUS score and the chest computed tomography score (r = 0.887, P < .001).
Conclusions: The most common abnormal LUS pattern in subjects with severe and critical COVID-19 pneumonia was B-lines, followed by lung consolidation. Bedside LUS can provide important information for pulmonary involvement in patients with COVID-19.
Keywords: lung; COVID-19; computed tomography; diagnostic imaging; pneumonia; ultrasound.