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Lung ultrasound for early diagnosis and severity assessment of pneumonia in patients with coronavirus disease 2019

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Background/Aims: Current evidence supports lung ultrasound as a point-ofcare alternative diagnostic tool for various respiratory diseases. We sought to determine the utility of lung ultrasound for early detection of pneumonia and for assessment of respiratory failure among patients with coronavirus disease 2019 (COVID-19). Methods: Six patients with confirmed COVID-19 by reverse transcription-polymerase chain reaction were enrolled. All had undergone chest X-ray and chest computed tomography (CT) on the day of admission and underwent multiple point-of-care lung ultrasound scans over the course of their hospitalization. Results: Lung ultrasound detected early abnormal findings of representative B-lines in a patient with a normal chest X-ray, corresponding to ground-glass opacities on the chest CT scan. The ultrasound findings improved as her clinical condition improved and her viral load decreased. In another minimally symptomatic patient without significant chest X-ray findings, the ultrasound showed B-lines, an early sign of pneumonia before abnormalities were detected on the chest CT scan. In two critically ill patients, ultrasound was performed to assess for evaluation of disease severity. In both patients, the clinicians conducted emergency rapid sequence intubation based on the ultrasound findings without awaiting the laboratory results and radiological reports. In two children, ultrasound was used to assess the improvement in their pneumonia, thus avoiding further imaging tests such as chest CT. Conclusions: Lung ultrasound is feasible and useful as a rapid, sensitive, and affordable point-of-care screening tool to detect pneumonia and assess the severity of respiratory failure in patients hospitalized with COVID-19.

Abstract

Background/Aims: Current evidence supports lung ultrasound as a point-ofcare alternative diagnostic tool for various respiratory diseases. We sought to determine the utility of lung ultrasound for early detection of pneumonia and for assessment of respiratory failure among patients with coronavirus disease 2019 (COVID-19). Methods: Six patients with confirmed COVID-19 by reverse transcription-polymerase chain reaction were enrolled. All had undergone chest X-ray and chest computed tomography (CT) on the day of admission and underwent multiple point-of-care lung ultrasound scans over the course of their hospitalization. Results: Lung ultrasound detected early abnormal findings of representative B-lines in a patient with a normal chest X-ray, corresponding to ground-glass opacities on the chest CT scan. The ultrasound findings improved as her clinical condition improved and her viral load decreased. In another minimally symptomatic patient without significant chest X-ray findings, the ultrasound showed B-lines, an early sign of pneumonia before abnormalities were detected on the chest CT scan. In two critically ill patients, ultrasound was performed to assess for evaluation of disease severity. In both patients, the clinicians conducted emergency rapid sequence intubation based on the ultrasound findings without awaiting the laboratory results and radiological reports. In two children, ultrasound was used to assess the improvement in their pneumonia, thus avoiding further imaging tests such as chest CT. Conclusions: Lung ultrasound is feasible and useful as a rapid, sensitive, and affordable point-of-care screening tool to detect pneumonia and assess the severity of respiratory failure in patients hospitalized with COVID-19.

참고문헌 (23)

  1. Wu Z, "Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19)outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention", JAMA (2020)[DOI]
  2. Li Y, "Coronavirus disease 2019 (COVID-19): role of chest CT in diagnosis and management", AJR Am J Roentgenol, 214, pp.1280~1286 (2020)
  3. Ai T, "Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19)in China: a report of 1014 cases", Radiology (2020)[DOI]
  4. Buonsenso D, "COVID-19 outbreak : less stethoscope, more ultrasound", Lancet Respir Med, 8, pp.e27~ (2020)
  5. Yicheng Fang, "Sensitivity of chest CT for COVID-19: comparison to RT-PCR", Radiology, 296(2), pp.E115~E117 (2020), Radiological Society of North America (RSNA)[DOI]
  6. Mojoli F, "Lung ultrasound for critically ill patients", Am J Respir Crit Care Med, 199, pp.701~714 (2019)
  7. Volpicelli G, "International evidence-based recommendations for point-of-care lung ultrasound", Intensive Care Med, 38, pp.577~591 (2012)
  8. Lichtenstein DA, "Relevance of lung ultrasound in the diagnosis of acute respiratory failure : the BLUE protocol", Chest, 134, pp.117~125 (2008)
  9. Rouby JJ, "Training for lung ultrasound score measurement in critically ill patients", Am J Respir Crit Care Med, 198, pp.398~401 (2018)
  10. Short J, "Visual versus automatic ultrasound scoring of lung B-lines : reliability and consistency between systems", Med Ultrason, 21, pp.45~49 (2019)
  11. Shokoohi H, "Enhanced point-of-care ultrasound applications by integrating automated feature-learning systems using deep learning", J Ultrasound Med, 38, pp.1887~1897 (2019)
  12. Copetti R, "Ultrasound diagnosis of pneumonia in children", Radiol Med, 113, pp.190~198 (2008)
  13. Ho MC, "Usefulness of lung ultrasound in the diagnosis of community-acquired pneumonia in children", Pediatr Neonatol, 56, pp.40~45 (2015)
  14. Enghard P, "Simplified lung ultrasound protocol shows excellent prediction of extravascular lung water in ventilated intensive care patients", Crit Care, 19, pp.36~ (2015)
  15. Volpicelli G, "Point-of-care multiorgan ultrasonography for the evaluation of undifferentiated hypotension in the emergency department", Intensive Care Med, 39, pp.1290~1298 (2013)
  16. Lui JK, "Diagnostic bedside ultrasonography for acute respiratory failure and severe hypoxemia in the medical intensive care unit : basics and comprehensive approaches", J Intensive Care Med, 32, pp.355~372 (2017)
  17. Zhao X, "The characteristics and clinical value of chest CT images of novel coronavirus pneumonia", Clin Radiol, 75, pp.335~340 (2020)
  18. Zhou Y, "Clinical features and chest CT findings of coronavirus disease 2019 in infants and young children", Zhongguo Dang Dai Er Ke Za Zhi, 22, pp.215~220 (2020)
  19. Chavez MA, "Lung ultrasound for the diagnosis of pneumonia in adults : a systematic review and meta-analysis", Respir Res, 15, pp.50~ (2014)
  20. Pereda MA, "Lung ultrasound for the diagnosis of pneumonia in children : a meta-analysis", Pediatrics, 135, pp.714~722 (2015)
  21. Yousef N, "Semiquantitative ultrasound assessment of lung aeration correlates with lung tissue inflammation", Ultrasound Med Biol, 46, pp.1258~1262 (2020)
  22. Cheung JC, "Staff safety during emergency airway management for COVID-19 in Hong Kong", Lancet Respir Med, 8, pp.e19~ (2020)
  23. Pan F, "Time course of lung changes at chest CT during recovery from coronavirus disease 2019(COVID-19)", Radiology, 295, pp.715~721 (2020)

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