Lung Ultrasound Findings in Patients with COVID-19
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COVID-19
Lung Ultrasound Findings in Patients with COVID-19 Daniel T. Marggrander 1
&
Frauke Borgans 2 & Volkmar Jacobi 3 & Holger Neb 4 & Timo Wolf 2
Accepted: 24 September 2020 # The Author(s) 2020
Abstract The current SARS-CoV-2 outbreak leads to a growing need of point-of-care thoracic imaging that is compatible with isolation settings and infection prevention precautions. We retrospectively reviewed 17 COVID-19 patients who received point-of-care lung ultrasound imaging in our isolation unit. Lung ultrasound was able to detect interstitial lung disease effectively; severe cases showed bilaterally distributed B-Lines with or without consolidations; one case showed bilateral pleural plaques. Corresponding to CT scans, interstitial involvement is accurately depicted as B-Lines on lung ultrasound. Lung ultrasound might be suitable for detecting interstitial involvement in a bedside setting under high security isolation precautions. Keywords COVID-19 . Lung ultrasound . SARS-CoV-2 . Interstitial pneumonia
Introduction SARS-CoV-2 is a coronavirus that emerged in December 2019 in Wuhan city, Province Hubei, China [1] that causes COVID-19, a viral disease that causes influenza-like illness, which can progress into pneumonia [2]. The evaluation of the extent of pulmonary involvement using radiographic imaging is problematic due to infection prevention and control (IPC) measures that must be taken and the sheer number of cases that need evaluation. Critically ill patients, especially those treated with mechanical ventilation and extracorporal Daniel T. Marggrander and Frauke Borgans contributed equally to this work. This article is part of the Topical Collection on Covid-19 * Daniel T. Marggrander [email protected] 1
Faculty of Medicine, J. W. Goethe University, Theodor-Stern-Kai 7 (H33 C), 60590 Frankfurt am Main, Germany
2
Department for Infectious Diseases, Centre of Internal Medicine II, University Hospital Frankfurt, Theodor-Stern-Kai 7 (H68-2), 60590 Frankfurt am Main, Germany
3
Institute of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7 (H23 C), 60590 Frankfurt am Main, Germany
4
Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Frankfurt, Theodor-Stern-Kai 7 (H23 C), 60590 Frankfurt am Main, Germany
circulation devices, are particularly difficult to transport in order to obtain computed tomography (CT-) scans, and bedside chest x-ray (CXR) remains an unreliably inaccurate and unsatisfactory imaging modality [3, 4]. Point-of-care ultrasound imaging however is available at the patients’ bedside and accelerates diagnostics in respiratory distress in comparison to radiographic imaging [5]. Reproducible imaging artifacts in lung ultrasound correspond to underlying conditions of pulmonary tissue. The healthy lung surface yields the sonographic image of pleural gliding as well so-called A-Lines, horizontal reverberations of the pleural line. Thickened interlobular septa, for instance in edema, fibrosis, or infectious di
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