Lung Ultrasound as a First-Line Test in the Evaluation of Post-COVID-19 Pulmonary Sequelae

Frontiers in Medicine

Xavier Muñoz¹  Antonio Álvarez¹  Diego Varona³  Jordi Andreu³  Laura Cabanzo³  Ana L. Sánchez-Martínez³  Jose M. Escudero³  Galo Granados⁴  Karina Loor⁴  Eva Polverino⁴  Almudena Felipe⁴  Mario Culebras⁴  Marta Arjona-Peris⁴  David Clofent⁴ 

[1] CIBER Enfermedades Respiratorias (CIBERES), Barcelona, Spain;Department of Respiratory Medicine, Vall D'Hebron University Hospital, Barcelona, Spain;Radiology Department, Vall D'Hebron University Hospital, Barcelona, Spain;Vall D'Hebron Institut de Recerca (VHIR), Barcelona, Spain;

关键词: COVID-19;    SARS-CoV-2;    lung ultrasound (LUS);    ultrasonography;    pulmonary sequelae;    interstitial lung disease (ILD);   

DOI  :  10.3389/fmed.2021.815732

来源: DOAJ

【 摘 要 】

Background: Interstitial lung sequelae are increasingly being reported in survivors of COVID-19 pneumonia. An early detection of these lesions may help prevent the development of irreversible lung fibrosis. Lung ultrasound (LUS) has shown high diagnostic accuracy in interstitial lung disease (ILD) and could likely be used as a first-line test for post-COVID-19 lung sequelae.Methods: Single-center observational prospective study. Follow-up assessments of consecutive patients hospitalized for COVID-19 pneumonia were conducted 2–5 months after the hospitalization. All patients underwent pulmonary function tests (PFTs), high-resolution computed tomography (HRCT), and LUS. Radiological alterations in HRCT were quantified using the Warrick score. The LUS score was obtained by evaluating the presence of pathological B-lines in 12 thoracic areas (range, 0–12). The correlation between the LUS and Warrick scores was analyzed.Results: Three hundred and fifty-two patients who recovered from COVID-19 pneumonia were recruited between July and September 2020. At follow-up, dyspnea was the most frequent symptom (69.3%). FVC and DLCO alterations were present in 79 (22.4%) and 234 (66.5%) patients, respectively. HRCT showed relevant interstitial lung sequelae (RILS) in 154 (43.8%) patients (Warrick score ≥ 7). The LUS score was strongly correlated with the HRCT Warrick score (r = 0.77) and showed a moderate inverse correlation with DLCO (r = −0.55). The ROC curve analysis revealed that a LUS score ≥ 3 indicated an excellent ability to discriminate patients with RILS (sensitivity, 94.2%; specificity, 81.8%; negative predictive value, 94.7%).Conclusions: LUS could be implemented as a first-line procedure in the evaluation of Post-COVID-19 interstitial lung sequelae. A normal LUS examination rules out the presence of these sequelae in COVID-19 survivors, avoiding the need for additional diagnostic tests such as HRCT.

【 授权许可】

Unknown