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J Clin Med . Lung Ultrasound Patterns and Clinical-Laboratory Correlates during COVID-19 Pneumonia: A Retrospective Study from North East Italy

tetano

Editor, Senior Moderator
J Clin Med


. 2021 Mar 20;10(6):1288.
doi: 10.3390/jcm10061288.
Lung Ultrasound Patterns and Clinical-Laboratory Correlates during COVID-19 Pneumonia: A Retrospective Study from North East Italy


Riccardo Senter[SUP] 1 [/SUP], Federico Capone[SUP] 1 [/SUP], Stefano Pasqualin[SUP] 2 [/SUP], Lorenzo Cerruti[SUP] 1 [/SUP], Leonardo Molinari[SUP] 1 [/SUP], Elisa Fonte Basso[SUP] 2 [/SUP], Nicol? Zanforlin[SUP] 2 [/SUP], Lorenzo Previato[SUP] 1 [/SUP], Alessandro Toffolon[SUP] 1 [/SUP], Caterina Sensi[SUP] 1 [/SUP], Gaetano Arcidiacono[SUP] 1 [/SUP], Davide Gorgi[SUP] 1 [/SUP], Renato Ippolito[SUP] 2 [/SUP], Enrico Nessi[SUP] 2 [/SUP], Pietro Pettenella[SUP] 2 [/SUP], Andrea Cellini[SUP] 2 [/SUP], Claudio Fossa[SUP] 2 [/SUP], Eleonora Vania[SUP] 2 [/SUP], Samuele Gardin[SUP] 3 [/SUP], Andi Sukthi[SUP] 4 [/SUP], Dora Luise[SUP] 5 [/SUP], Maria Teresa Giordani[SUP] 5 [/SUP], Mirko Zanatta[SUP] 6 [/SUP], Sandro Savino[SUP] 1 [/SUP], Vito Cianci[SUP] 2 [/SUP], Andrea Sattin[SUP] 3 [/SUP], Anna Maria[SUP] 3 [/SUP], Andrea Vianello[SUP] 4 [/SUP], Raffaele Pesavento[SUP] 7 [/SUP], Sandro Giannini[SUP] 1 [/SUP], Angelo Avogaro[SUP] 1 [/SUP], Roberto Vettor[SUP] 1 [/SUP], Gian Paolo Fadini[SUP] 1 [/SUP], Alois Saller[SUP] 1 [/SUP]



Affiliations

Abstract

Background and aim: Lung ultrasound (LUS) is a convenient imaging modality in the setting of coronavirus disease-19 (COVID-19) because it is easily available, can be performed bedside and repeated over time. We herein examined LUS patterns in relation to disease severity and disease stage among patients with COVID-19 pneumonia.
Methods: We performed a retrospective case series analysis of patients with confirmed SARS-CoV-2 infection who were admitted to the hospital because of pneumonia. We recorded history, clinical parameters and medications. LUS was performed and scored in a standardized fashion by experienced operators, with evaluation of up to 12 lung fields, reporting especially on B-lines and consolidations.
Results: We included 96 patients, 58.3% men, with a mean age of 65.9 years. Patients with a high-risk quick COVID-19 severity index (qCSI) were older and had worse outcomes, especially for the need for high-flow oxygen. B-lines and consolidations were located mainly in the lower posterior lung fields. LUS patterns for B-lines and consolidations were significantly worse in all lung fields among patients with high versus low qCSI. B-lines and consolidations were worse in the intermediate disease stage, from day 7 to 13 after onset of symptoms. While consolidations correlated more with inflammatory biomarkers, B-lines correlated more with end-organ damage, including extrapulmonary involvement.
Conclusions: LUS patterns provide a comprehensive evaluation of patients with COVID-19 pneumonia that correlated with severity and dynamically reflect disease stage. LUS patterns may reflect different pathophysiological processes related to inflammation or tissue damage; consolidations may represent a more specific sign of localized disease, whereas B-lines seem to be also dependent upon generalized illness due to SARS-CoV-2 infection.

Keywords: B-lines; COVID-19; consolidations; lung ultrasound.
 
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