Ultrasonic characteristics and severity assessment of lung ultrasound in COVID-19 pneumonia in wuhan, china: A retrospective, observational study
Date
2020Author
Zhu, Fengxue
Zhao, Xiujuan
Wang, Tianbing
Wang, Zhenzhou
Guo, Fuzheng
Xue, Haiyan
Chang, Panpan
Liang, Hansheng
Ni, Wentao
Wang, Yaxin
Chen, Lei
Jiang, Baoguo
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Show full item recordAbstract
The clinical application of lung ultrasound (LUS) in the assessment of coronavirus disease 2019
(COVID-19) pneumonia severity remains limited. Herein, we investigated the role of LUS imaging
in COVID-19 pneumonia patients and the relationship between LUS findings and disease severity.
This was a retrospective, observational study at Tongji Hospital in Wuhan, on 48 recruited patients
with COVID-19 pneumonia, including 32 non-critically ill patients and 16 critically ill patients.
LUS was performed and the respiratory rate oxygenation (ROX) index, disease severity, and
confusion, urea nitrogen, respiratory rate, blood pressure and age (CURB-65) score were recorded
on days 0–7, 8–14, and 15–21 after symptom onset. Lung images were divided into 12 regions, and
the LUS score (0–36 points) was calculated. Chest computed tomography (CT) scores (0–20 points)
were also recorded on days 0–7. Correlations between the LUS score, ROX index, and CURB-65
scores were examined. LUS detected COVID-19 pneumonia in 38 patients. LUS signs included B
line (34/38, 89.5%), consolidation (6/38, 15.8%), and pleural effusion (2/41, 5.3%). Most cases
showed more than one lesion (32/38, 84.2%) and involved both lungs (28/38, 73.7%). Compared
with non-critically ill patients, the LUS scores of critically ill patients were higher (12 (10–18) vs 2
(0–5), p < 0.001). The LUS score showed significant negative correlations with the ROX index on
days 0–7 (r = –0.85, p < 0.001), days 8–14 (r = –0.71, p < 0.001), and days 15–21 (r = –0.76,
p < 0.001) after symptom onset. However, the LUS score was positively correlated with the CT
score (r = 0.82, p < 0.001). The number of patients with LUS-detected lesions decreased from 27
cases (81.8%) to 20 cases (46.5%), and the LUS scores significantly decreased from 4 (2–10) to 0
(0–5) (p < 0.001) from days 0–7 to 17–21. We conclude that LUS can detect lung lesions in COVID-19 pneumonia patients in a portable, real-time, and safe manner. Thus, LUS is helpful in assessing
COVID-19 pneumonia severity in critically ill patients.
Link to resource
https://doi.org/10.1016/j.eng.2020.09.007Collections
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