[Lung ultrasound in patients with SARS-CoV-2 infection]

Pulmonary Findings in Hospitalized COVID-19 Patients Assessed by Lung Ultrasonography (LUS) - A Prospective Registry Study

PURPOSE

This prospective two-centre study investigated localisation-dependent lesion patterns in COVID-19 with standard lung ultrasonography (LUS) and their relationship with thoracic computed tomography (CT) and clinical parameters.

MATERIALS AND METHODS

Between April 2020 and April 2021, 52 SARS-CoV-2-positive patients in two hospitals were examined by means of LUS for "B-lines", fragmented pleura, consolidation and air bronchogram in 12 lung regions and for pleural effusions. A newly developed LUS score based on the number of features present was correlated with clinical parameters (respiration, laboratory parameters) and the CT and analysed with respect to the 30- and 60-day outcome. All patients were offered an outpatient LUS follow-up.

RESULTS

The LUS and CT showed a bilateral, partially posteriorly accentuated lesion distribution pattern. 294/323 (91%) of CT-detected lesions were pleural. The LUS score showed an association with respiratory status and C-reactive protein; the correlation with the CT score was weak (Spearman's rho = 0.339, p < 0.001). High LUS scores on admission were also observed in patients who were discharged within 30 days. LUS during follow-up showed predominantly declining LUS scores.

CONCLUSION

The LUS score reflected the clinical condition of the patients. No conclusion could be made on the prognostic value of the LUS, because of the low event rate. The LUS and CT score showed no sufficient correlation. This is probably due to different physical principles, which is why LUS could be of complementary value.

Lung ultrasound in the diagnosis of COVID-19-associated pneumonia

Over the past decades, lung ultrasound in the diagnosis of lung diseases has become widespread. Ultrasound examination has a number of advantages (no radiation exposure, real-time imaging, clear visualization of the subpleural lung regions and costophrenic angles), which make it possible to use ultrasound to monitor the dynamics of pneumonia in children and pregnant women. Currently, in the context of the COVID-19 pandemic, lung ultrasound is widely used due to its high diagnostic efficiency, which is comparable with classical radiography and X-ray computed tomography (CT) by a number of parameters.

The article describes the method of lung ultrasound and the radiographic pattern of COVID-19-associated pneumonia. It also provides a review of the literature, according to which the severity of pneumonia was determined, depending on the radiographic pattern, and the need for a lung ultrasound was identified.

The article indicates that information on assessment of the radiographic pattern of the lungs at runtime in different variants of the course of coronavirus infection, as well as many methodological issues, including the frequency of second-look lung ultrasound, has not been sufficiently studied.

["B problems" in non-traumatic resuscitation room management]

In the primary survey of resuscitation room management in critically ill nontrauma patients, the ABCDE (airway, breathing, circulation, disability, exposure) approach is used for immediate recognition and treatment of life-threatening conditions. "B problems" are associated with respiratory failure and require immediate treatment. The pathogenesis is diverse, especially in the nontrauma resuscitation room. Clinical examination, emergency sonography and knowledge of oxygenation techniques and ventilation are important components of diagnosis and therapy. Standardized procedures and regular training in the emergency room are of fundamental importance.