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Review
. 2020 Oct;30(Suppl 2):S1-S5.
doi: 10.4103/jcecho.jcecho_53_20. Epub 2020 Oct 27.

Lung Semiotics Ultrasound in COVID-19 Infection

Agatella Barchitta  1 , Mauro Pepi  2 , Ines Paola Monte  3 , Giuseppe Trocino  4 , Andrea Barbieri  5 , Quirino Ciampi  6 , Alberto Cresti  7 , Sofia Miceli  8 , Licia Petrella  9 , Frank Benedetto  10 , Maio Daniele  11 , Francesco Antonini-Canterin  12
Affiliations
Review

Lung Semiotics Ultrasound in COVID-19 Infection

Agatella Barchitta et al. J Cardiovasc Echogr. 2020 Oct.

Abstract

This paper aims to highlight the usefulness of "bedside" lung ultrasound in the context of the COVID-19 pandemic. The evaluation of lung artifacts allows to detect at the subpleural level the presence of an altered "tissue/air" ratio both in case of consolidative or not consolidative lung lesions. Furthermore, lung ultrasound allows acquiring topographical images of the lesions, establishing their extension on the lung surface as well as their evolution or regression over time, without radiation exposure. Since ultrasound semiotics is already widely known and described in other similar diseases (acute respiratory distress syndrome, interstitial flu virus, and pneumonia), thoracic ultrasound is a useful diagnostic tool in different scenarios in the COVID-19 pandemic: in the first triage of symptomatic patients, both in the prehospital setting or in the emergency department, in the prognostic stratification and monitoring of patients with pneumonia, and in the management of patients in the intensive care unit. Moreover, "bedside" lung ultrasound can reduce the number of health-care workers exposed to the virus during patient assessment and treatment.

Keywords: Artifacts; COVID-19; lung ultrasound; semiotics.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) pleural line and A-line. (b) Multiple A-lines. (c) M-mode “seashore sign”
Figure 2
Figure 2
Two B-lines
Figure 3
Figure 3
M-mode pneumothorax stratosphere sign
Figure 4
Figure 4
(a) Thickened interlobular septa. (b) Type B pattern in cardiogenic edema. (c) Pleural effusion
Figure 5
Figure 5
(a) Type B pattern in acute respiratory distress syndrome. (b) Type B pattern in ARDS with spared areas
Figure 6
Figure 6
(a) Lung consolidation. (b) Lung consolidation with visible bronchograms
Figure 7
Figure 7
Sequential interpretation of lung ultrasound findings. The blue boxes highlight ultrasound findings in the COVID-19 patient. Modified from Via et al.
See this image and copyright information in PMC

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