Journal of Clinical Medicine (Mar 2021)

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

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

DOI
https://doi.org/10.3390/jcm10061288
Journal volume & issue
Vol. 10, no. 6
p. 1288

Abstract

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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.

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