Portable Pocket-Sized Ultrasound Scanner for the Evaluation of Lung Involvement in Coronavirus Disease 2019 Patients

Abstract

Ultrasound imaging of the lung (LUS) and associated tissues has demonstrated clinical utility in coronavirus disease 2019 (COVID-19) patients. The aim of the present study was to evaluate the possibilities of a portable pocket-sized ultrasound scanner in the evaluation of lung involvement in patients with COVID-19 pneumonia. We conducted 437 paired readings in 34 LUS evaluations of hospitalized individuals with COVID-19. The LUS scans were performed on the same day with a standard high-end ultrasound scanner (Venue GO, GE Healthcare, Chicago, IL, USA) and a pocket-sized ultrasound scanner (Butterfly iQ, Butterfly Network Inc., Guilford, CT, USA). Fourteen scans were performed on individuals with severe cases, 11 on individuals with moderate cases and nine on individuals with mild cases. No difference was observed between groups in days since onset of symptoms (23.29 ± 10.07, 22.91 ± 8.91 and 28.56 ± 11.13 d, respectively; p = 0.38). No significant differences were found between LUS scores obtained with the high-end and the portable pocket-sized ultrasound scanner. LUS scores in individuals with mild respiratory impairment were significantly lower than in those with moderate and severe cases. Our study confirms the possibilities of portable pocket-sized ultrasound imaging of the lung in COVID-19 patients. Portable pocket-sized ultrasound scanners are cheap, easy to handle and equivalent to standard scanners for non-invasive assessment of severity and dynamic observation of lung lesions in COVID-19 patients.

Keywords: Acute respiratory failure; COVID-19; Handheld; Imaging; Lung ultrasound; Pneumonia; SARS-CoV-2.

Fig. 1

Correlation of mean scores obtained with the two instruments, according to disease severity.

Fig. 2

Bland–Altman plot showing the level of bias (solid line) and limits of agreement.

Fig. 3

Sample images of different grades of severity of lung impairment obtained with the handheld ultrasound scanner. (a) Normal aeration, presence of A-lines or no more than two isolated B-lines; (b) moderate loss of lung aeration, multiple well-defined B-lines; (c) severe loss of lung aeration, multiple coalescent B-lines; (d) lung consolidation and tissue-like pattern.