Role of lung ultrasound in identifying COVID-19 pneumonia in patients with negative swab during the outbreak
Lung ultrasound is a reasonable tool for detection of manifestations of COVID-19, to facilitate the division of patients flow of infected with SARS-CoV-2 from those affected by other pathologies. Often, a reason for the incorrect separation of the flows is the possibility of false-negative rRT-PCR results. We aimed to evaluate the advantages of performing Lung Ultrasound (LUS) in patients with a negative swab, to confirm the suspicious of COVID-19 at the bedside, according to the recent findings of typical lung ultrasound lesions of COVID19 related pneumonia. We analyzed 11 non-critical patients admitted to Emergency Department in the Internal Medicine ward, during outbreak, as Covid-19 negative patients affected by pneumonia. The result of the ultrasound findings conditioned the consequent allocation of the patient. 9/11 patients had typical LUS findings for COVID-19, but only 3/11 patients had a second positive nasopharyngeal swab, and 2/11 had positive swab on pleural fluid. 6/11 patients remained negative with strongly suspicious LUS lesions, and so treated and isolated as Covid-19 positive. 2/11 had negative swab and none LUS findings, thus treated as affected by other pathologies. These findings clearly show how LUS plays an important role together with the chest x-ray in identifying patients with interstitial pneumonia from COVID-19.
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020 Feb 15;395(10223):497-506. DOI: https://doi.org/10.1016/S0140-6736(20)30183-5
Zu Z Y, Jiang M D, Xu P P,et al. Coronavirus Disease 2019 (COVID-19): A Perspective from China. Radiology 2020 February; https://doi.org/10.1148/radiol.2020200490 DOI: https://doi.org/10.1148/radiol.2020200490
FanY, Zhang H, Xie J, et al. Sensitivity of Chest TC for COVID-19: Comparision to RT-PCR. Radiology 2020:200432. doi: 10.1148/radiol.2020200432 DOI: https://doi.org/10.1148/radiol.2020200432
Pan F, Ye T, Sun P, et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia. Radiology 2020:200370. doi: 10.1148/radiol.2020200370. Published February 1, 2020. Accessed February 13, 2020
Mojoli F, Bouhemad B, Mongodi S, Lichtenstein D. Lung Ultrasound for Critically Ill Patients. Am J Respir Crit Care Med. 2019 Mar 15;199(6):701-714. DOI: https://doi.org/10.1164/rccm.201802-0236CI
Mayo PH, Copetti R, Feller-Kopman D, et al. Thoracic ultrasonography: a narrative review. Intensive Care Med. 2019 Sep;45(9):1200-1211 DOI: https://doi.org/10.1007/s00134-019-05725-8
Soldati G, Demi M, Smargiassi A, et al. The role of ultrasound lung artifacts in the diagnosis of respiratory diseases. Expert Rev Respir Med. 2019 Feb;13:163-172. DOI: https://doi.org/10.1080/17476348.2019.1565997
Yang Y, Wang Z, et al. Application of pulmonary ultrasound in severe H7N9. Chinese Journal of Medical Ultrasound (Electronic Edition) 2019; 16(01): 72-76.
Soldati G, Smargiassi A, Inchingolo R, et al Proposal for international standardization of the use of lung ultrasound for COVID-19 patients; a simple, quantitative, reproducible method. Journal of Ultrasound in Medicine First published: 30 March 2020 https://doi.org/10.1002/jum.15285 DOI: https://doi.org/10.1002/jum.15285
Huang Y, Wang S, Liu Y, al. A preliminary study on the ultrasonic manifestations of peripulmonary lesions of non-critical novel coronavirus pneumonia (COVID-19). https://dx.doi.org/10.2139/ssrn.3544750 DOI: https://doi.org/10.2139/ssrn.3544750
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