Lung Ultrasound for COVID-19 Pneumonia Diagnosis?

March 19, 2020

Early research indicates lung ultrasound can identify patients in the emergency department.

Bedside lung ultrasound could be used to effectively identify patients with COVID-19 pneumonia, according to a preliminary study.

While chest CT is largely considered the modality of choice to estimate pulmonary damage, such scans aren’t always available in the emergency room setting. As an alternative, bedside lung ultrasound is frequently used to assess patients for acute respiratory failure, frequently diagnosing pneumonia.

As the global infection rates of COVID-19 continue to rise, investigators in Italy, led by Erika Poggiali, M.D., from Ospedale Guglielmo da Saliceto, evaluated whether lung ultrasound could be an effective tool in also identifying patients who have pneumonia specifically associated with the virus. They published their results in a Letter to the Editor recently in Radiology.

To determine whether ultrasound could feasibly be used to pinpoint COVID-19 pneumonia, researchers analyzed 12 emergency department patients (nine men and three women) who had exhibited flu-like symptoms within the previous 4-10 days, as well as COVID-19 infection. These individuals received both lung ultrasound and CT.

According to the results, the CT scans correlated strongly with the ultrasounds – all 12 patients had ground-glass opacity, and five patients had a crazy-paving pattern. Scans identified a diffuse B-pattern with spared areas in all patients, and only three had posterior subpleural consolidations.

Ultimately, four patients were confirmed to have organizing pneumonia – a finding that was also detected via lung ultrasound.

The investigators acknowledged the research is early, but asserted the results could be used to impact patient care.

“We are aware that our data are preliminary and further studies are necessary to confirm the role of lung ultrasound in the diagnosis and management of COVID-19, but we strongly recommend the use of bedside ultrasound for the early diagnosis of COVID-19 pneumonia in all the patients who presented to the emergency department with flu-like symptoms in novel COVID-19 era,” Poggiali wrote.