RT Journal Article
SR Electronic
T1 Lung ultrasound findings in patients with novel SARS-CoV-2
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00238-2020
DO 10.1183/23120541.00238-2020
VO 6
IS 4
A1 Mark E. Haaksma
A1 Micah L.A. Heldeweg
A1 Jorge E. Lopez Matta
A1 Jasper M. Smit
A1 Jessica D. van Trigt
A1 Jip S. Nooitgedacht
A1 Carlos V. Elzo Kraemer
A1 Mark van de Wiel
A1 Armand R.J. Girbes
A1 Leo Heunks
A1 David J. van Westerloo
A1 Pieter R. Tuinman
YR 2020
UL http://openres.ersjournals.com/content/6/4/00238-2020.abstract
AB Background Over 2 million people worldwide have been infected with severe acute respiratory distress syndrome-coronavirus-2 (SARS CoV-2). Lung ultrasound has been proposed to diagnose and monitor it, despite the fact that little is known about the ultrasound appearance due to the novelty of the illness. The aim of this manuscript is to characterise the lung ultrasonographic appearance of critically ill patients with SARS-CoV-2 pneumonia, with particular emphasis on its relationship with the time course of the illness and clinical parameters.Methods Adult patients from the intensive care unit of two academic hospitals who tested positive for SARS-CoV-2 were included. Images were analysed using internationally recognised techniques which included assessment of the pleura, number of B-lines, pathology in the PLAPS (posterolateral alveolar and/or pleural syndrome) point, bedside lung ultrasound in emergency profiles, and the lung ultrasound score. The primary outcomes were frequencies, percentages and differences in lung ultrasound findings overall and between short (≤14 days) and long (>14 days) durations of symptoms and their correlation with clinical parameters.Results In this pilot observational study, 61 patients were included with 76 examinations available for analysis. 26% of patients had no anterior lung abnormalities, while the most prevalent pathological ultrasound findings were thickening of the pleura (42%), ≥3 B-lines per view (38%) and presence of PLAPS (74%). Patients with “long” duration of symptoms presented more frequently with a thickened and irregular pleura (32 (21%) versus 11 (9%)), C-profile (18 (47%) versus 8 (25%)) and pleural effusion (14 (19%) versus 3 (5%)), compared to patients with short duration of symptoms. Lung ultrasound findings did not correlate with arterial oxygen tension/inspiratory oxygen fraction ratio, fluid balance or dynamic compliance.Conclusion SARS-CoV-2 results in significant, but not specific, ultrasound changes, with decreased lung sliding, thickening of the pleura and a B-profile being the most commonly observed. With time, a thickened and irregular pleura, C-profile and pleural effusion become more common findings. When screening patients, a comprehensive ultrasound protocol might be necessary.Lung ultrasound is a valuable tool for detection and monitoring of pulmonary changes in #SARSCoV2 infection https://bit.ly/3lfWrUo