Lung ultrasound for detection of pneumonic changes in patients with COVID-19 infection

Abstract

Background and Aim Given the pandemic crisis of COVID-19 pneumonia, the computed tomography (CT) chest is widely used for initial management of patients with suspected COVID-19 because of its well-known high sensitivity for detection of COVID-19 pneumonia, but its cost, which decreases its availability for certain populations, risk of radiation, need for transportation of the patient, the burden of proper disinfection of the CT room and its unsuitability for some patients like pregnant and lactating women certainly lead to the necessity for a more advantageous tool like lung ultrasound that could solve many of the previous obstacles encountered while deciding to perform the CT chest. This study aims to determine the suitability of lung ultrasound as an alternative to CT chest to aid in the initial management of these patients. The aim was to determine the value of lung ultrasound in the diagnosis of lung parenchymal affection in patients with COVID-19. Patients and methods A prospective including 150 patients was carried out in the Chest, Interventional Radiology and Clinical Pathology Departments in Bab-El-Sha’aria and Al-Hussin Hospitals, Al-Azhar University, during the period from May 2020 to September 2020. Lung ultrasound was performed in 150 patients with COVID-19 pneumonia diagnosed based on the integrated clinical, laboratory, and CT chest radiological data. Results Among 150 patients, there were 86 males and 64 males, ranging in age from 30 to 75 years and a mean age of 55.8±12.1 years. Bilateral lung infiltrates in the CT scan were present in 146 patients (97.3%), CXR infiltrates were present in 63 patients (42%), sonographic evidence of pleuropulmonary involvement was present in 139 patients (92.7%), B lines and pleural line thickening were present in all patients with ultrasound findings (100%), subpleural consolidation associated with B lines was present only in 33 patients (23.7%) and pleural effusion was absent in all cases; crackles were only present in 53 (35.3%) patients. Conclusion Because of its simplicity in interpretation, bedside availability, lack of risk of radiation and good sensitivity in the detection of lung parenchymal affection, the chest ultrasound is a useful tool in the management of patients with symptoms suspicious of COVID-19 infection and seems to be a suitable substitute for the CT chest in such circumstances.