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Lung Ultrasound May Support Diagnosis and Monitoring of COVID-19 Pneumonia.
Ultrasound Med Biol. 2020 11; 46(11):2908-2917.UM

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) is characterized by severe pneumonia and/or acute respiratory distress syndrome in about 20% of infected patients. Computed tomography (CT) is the routine imaging technique for diagnosis and monitoring of COVID-19 pneumonia. Chest CT has high sensitivity for diagnosis of COVID-19, but is not universally available, requires an infected or unstable patient to be moved to the radiology unit with potential exposure of several people, necessitates proper sanification of the CT room after use and is underutilized in children and pregnant women because of concerns over radiation exposure. The increasing frequency of confirmed COVID-19 cases is striking, and new sensitive diagnostic tools are needed to guide clinical practice. Lung ultrasound (LUS) is an emerging non-invasive bedside technique that is used to diagnose interstitial lung syndrome through evaluation and quantitation of the number of B-lines, pleural irregularities and nodules or consolidations. In patients with COVID-19 pneumonia, LUS reveals a typical pattern of diffuse interstitial lung syndrome, characterized by multiple or confluent bilateral B-lines with spared areas, thickening of the pleural line with pleural line irregularity and peripheral consolidations. LUS has been found to be a promising tool for the diagnosis of COVID-19 pneumonia, and LUS findings correlate fairly with those of chest CT scan. Compared with CT, LUS has several other advantages, such as lack of exposure to radiation, bedside repeatability during follow-up, low cost and easier application in low-resource settings. Consequently, LUS may decrease utilization of conventional diagnostic imaging resources (CT scan and chest X-ray). LUS may help in early diagnosis, therapeutic decisions and follow-up monitoring of COVID-19 pneumonia, particularly in the critical care setting and in pregnant women, children and patients in areas with high rates of community transmission.

Authors+Show Affiliations

Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, Florence, Italy. Electronic address: marco.allinovi@gmail.com.Department of Medicine and Surgery, University of Parma, Parma, Italy; Geriatric-Rehabilitation Department, Parma University Hospital, Parma, Italy.Department of Emergency Medicine and Trauma Center, Meyer University Children's Hospital, Florence, Italy.Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Mood Disorders Program, Tufts Medical Center, Boston, Massachusetts, USA.Dipartimento di Medicina e Chirurgia, Università degli studi di Parma, Parma, Italy.School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Clinical Epidemiology and HTA, IRCCS San Raffaele Scientific Institute, Milan, Italy.Emergency Department, Intensive Care Unit and Regional ECMO Referral Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.CESISLAV, University of Parma, Parma, Italy.Division of General Medicine, ASST Garda, Manerbio, Italy.Institute of Materials for Electronics and Magnetism, Italian National Research Council, Parma, Italy.Department of Emergency Medicine and Trauma Center, Meyer University Children's Hospital, Florence, Italy.Respiratory Department, Hospital Guglielmo da Saliceto, Piacenza, Italy.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32807570

Citation

Allinovi, Marco, et al. "Lung Ultrasound May Support Diagnosis and Monitoring of COVID-19 Pneumonia." Ultrasound in Medicine & Biology, vol. 46, no. 11, 2020, pp. 2908-2917.
Allinovi M, Parise A, Giacalone M, et al. Lung Ultrasound May Support Diagnosis and Monitoring of COVID-19 Pneumonia. Ultrasound Med Biol. 2020;46(11):2908-2917.
Allinovi, M., Parise, A., Giacalone, M., Amerio, A., Delsante, M., Odone, A., Franci, A., Gigliotti, F., Amadasi, S., Delmonte, D., Parri, N., & Mangia, A. (2020). Lung Ultrasound May Support Diagnosis and Monitoring of COVID-19 Pneumonia. Ultrasound in Medicine & Biology, 46(11), 2908-2917. https://doi.org/10.1016/j.ultrasmedbio.2020.07.018
Allinovi M, et al. Lung Ultrasound May Support Diagnosis and Monitoring of COVID-19 Pneumonia. Ultrasound Med Biol. 2020;46(11):2908-2917. PubMed PMID: 32807570.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lung Ultrasound May Support Diagnosis and Monitoring of COVID-19 Pneumonia. AU - Allinovi,Marco, AU - Parise,Alberto, AU - Giacalone,Martina, AU - Amerio,Andrea, AU - Delsante,Marco, AU - Odone,Anna, AU - Franci,Andrea, AU - Gigliotti,Fabrizio, AU - Amadasi,Silvia, AU - Delmonte,Davide, AU - Parri,Niccolò, AU - Mangia,Angelo, Y1 - 2020/07/20/ PY - 2020/04/01/received PY - 2020/06/23/revised PY - 2020/07/16/accepted PY - 2020/8/19/pubmed PY - 2020/10/2/medline PY - 2020/8/19/entrez KW - Acute respiratory disease syndrome KW - B-Lines KW - COVID-19 KW - Interstitial syndrome KW - Lung ultrasound KW - Pneumonia SP - 2908 EP - 2917 JF - Ultrasound in medicine & biology JO - Ultrasound Med Biol VL - 46 IS - 11 N2 - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) is characterized by severe pneumonia and/or acute respiratory distress syndrome in about 20% of infected patients. Computed tomography (CT) is the routine imaging technique for diagnosis and monitoring of COVID-19 pneumonia. Chest CT has high sensitivity for diagnosis of COVID-19, but is not universally available, requires an infected or unstable patient to be moved to the radiology unit with potential exposure of several people, necessitates proper sanification of the CT room after use and is underutilized in children and pregnant women because of concerns over radiation exposure. The increasing frequency of confirmed COVID-19 cases is striking, and new sensitive diagnostic tools are needed to guide clinical practice. Lung ultrasound (LUS) is an emerging non-invasive bedside technique that is used to diagnose interstitial lung syndrome through evaluation and quantitation of the number of B-lines, pleural irregularities and nodules or consolidations. In patients with COVID-19 pneumonia, LUS reveals a typical pattern of diffuse interstitial lung syndrome, characterized by multiple or confluent bilateral B-lines with spared areas, thickening of the pleural line with pleural line irregularity and peripheral consolidations. LUS has been found to be a promising tool for the diagnosis of COVID-19 pneumonia, and LUS findings correlate fairly with those of chest CT scan. Compared with CT, LUS has several other advantages, such as lack of exposure to radiation, bedside repeatability during follow-up, low cost and easier application in low-resource settings. Consequently, LUS may decrease utilization of conventional diagnostic imaging resources (CT scan and chest X-ray). LUS may help in early diagnosis, therapeutic decisions and follow-up monitoring of COVID-19 pneumonia, particularly in the critical care setting and in pregnant women, children and patients in areas with high rates of community transmission. SN - 1879-291X UR - https://www.unboundmedicine.com/medline/citation/32807570/Lung_Ultrasound_May_Support_Diagnosis_and_Monitoring_of_COVID_19_Pneumonia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-5629(20)30333-1 DB - PRIME DP - Unbound Medicine ER -