Multicentre study on the accuracy of lung ultrasound in the diagnosis and monitoring of respiratory sequelae in the medium and long term in patients with COVID-19

Frontiers in Medicine

Medicine

Ana Núñez Ares¹  Olalla Castro Anón²  Jorge González Ramírez³  Diego Ferrer Pargada⁴  Ana Sánchez Fernández⁵  Rosa Cordovilla⁵  Aurelio Wangüemert Pérez⁶  Mar Valdivia Salas⁷  Javier Pérez Pallares⁷  Paola Ordoñez Gómez⁸  Cristina Ramos Hernández⁹  Irene Lojo Rodriguez⁹  Alberto Fernández Villar⁹  Almudena González Montaos⁹  Fernando Vargas Ursúa⁹  Maribel Botana Rial⁹  Amara Tilve Gomez^1,10 

[1] Albacete University Hospital Complex, Pneumology Service, Albacete, Spain;Lucus Augusti Hospital, Pneumology Service, Lugo, Spain;Lucus Augusti Hospital, Radiology Service, Lugo, Spain;Marqués de Valdecilla Hospital, Servicio de Neumología, Pneumology Service, Valencia, Spain;Salamanca University Clinical Hospital, Pneumology Service, Salamanca, Spain;San Juan de Dios Hospital in Tenerife, Pneumology Service, Tenerife, Spain;Santa Lucía de Cartagena General University Hospital, Pneumology Service, Cartagena, Spain;Valencia University Clinical Hospital, Pneumology Service, Valencia, Spain;Álvaro Cunqueiro Hospital in Vigo, Pneumology Service, NeumoVigo I + i, Southern Galicia Biomedical Research Institute (IISGS), Vigo, Spain;Álvaro Cunqueiro Hospital in Vigo, Radiology Service, Vigo, Spain;

关键词: LUS;    elastography;    ultrasound;    COVID-19;    SWE;   

DOI  :  10.3389/fmed.2023.1199666

 received in 2023-04-03, accepted in 2023-05-03,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionLung ultrasound (LUS) has proven to be a more sensitive tool than radiography (X-ray) to detect alveolar-interstitial involvement in COVID-19 pneumonia. However, its usefulness in the detection of possible pulmonary alterations after overcoming the acute phase of COVID-19 is unknown. In this study we proposed studying the utility of LUS in the medium- and long-term follow-up of a cohort of patients hospitalized with COVID-19 pneumonia.Materials and methodsThis was a prospective, multicentre study that included patients, aged over 18 years, at 3 ± 1 and 12 ± 1 months after discharge after treatment for COVID-19 pneumonia. Demographic variables, the disease severity, and analytical, radiographic, and functional clinical details were collected. LUS was performed at each visit and 14 areas were evaluated and classified with a scoring system whose global sum was referred to as the “lung score.” Two-dimensional shear wave elastography (2D-SWE) was performed in 2 anterior areas and in 2 posterior areas in a subgroup of patients. The results were compared with high-resolution computed tomography (CT) images reported by an expert radiologist.ResultsA total of 233 patients were included, of whom 76 (32.6%) required Intensive Care Unit (ICU) admission; 58 (24.9%) of them were intubated and non-invasive respiratory support was also necessary in 58 cases (24.9%). Compared with the results from CT images, when performed in the medium term, LUS showed a sensitivity (S) of 89.7%, specificity (E) 50%, and an area under the curve (AUC) of 78.8%, while the diagnostic usefulness of X-ray showed an S of 78% and E of 47%. Most of the patients improved in the long-term evaluation, with LUS showing an efficacy with an S of 76% and E of 74%, while the X-ray presented an S of 71% and E of 50%. 2D-SWE data were available in 108 (61.7%) patients, in whom we found a non-significant tendency toward the presentation of a higher shear wave velocity among those who developed interstitial alterations, with a median kPa of 22.76 ± 15.49) versus 19.45 ± 11.39; p = 0.1).ConclusionLung ultrasound could be implemented as a first-line procedure in the evaluation of interstitial lung sequelae after COVID-19 pneumonia.

【 授权许可】

Unknown   
Copyright © 2023 Ramos Hernández, Tilve Gomez, Sánchez Fernández, Cordovilla, Núñez Ares, Ordoñez Gómez, Wangüemert Pérez, Castro Anón, González Ramírez, Valdivia Salas, Pérez Pallares, Ferrer Pargada, Vargas Ursúa, Lojo Rodriguez, González Montaos, Botana Rial and Fernández Villar.