Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 7;11(8):2067.
doi: 10.3390/jcm11082067.

Role of Lung Ultrasound in the Management of Patients with Suspected SARS-CoV-2 Infection in the Emergency Department

Andrea Boccatonda  1 , Alice Grignaschi  1 , Antonella Maria Grazia Lanotte  1 , Giulio Cocco  2 , Gianpaolo Vidili  3 , Fabrizio Giostra  1 , Cosima Schiavone  2
Affiliations

Role of Lung Ultrasound in the Management of Patients with Suspected SARS-CoV-2 Infection in the Emergency Department

Andrea Boccatonda et al. J Clin Med. .

Abstract

Background: The lung ultrasound (LUS) score has been proposed as an optimal scheme for the ultrasound study of patients with suspected/confirmed COVID-19 pneumonia. The aims of our study were to evaluate the use of lung ultrasound as a diagnostic tool for diagnosing SARS-CoV-2 pneumonia, to examine the validity of the LUS score for the diagnosis of COVID-19 pneumonia, and to correlate this score with hospitalization rate and 30-day mortality. Materials and Methods: A retrospective analysis was performed on 1460 patients who were referred to the General Emergency Department of the S. Orsola-Malpighi Hospital from April 2020 to May 2020 for symptoms suspected to indicate SARS-CoV-2 infection. The ultrasound examination was based on a common execution scheme called the LUS score, as previously described. Results and Conclusions: The LUS score was found to correlate with the degree of clinical severity and respiratory failure (paO2/FiO2 ratio and the alveolar−arterial gradient increase than expected for age). It was shown that COVID-19 patients with an LUS score of >7 require the use of oxygen support, and a value of >10 is associated with an increased risk of oro-tracheal intubation. The LUS score was found to present higher values in hospitalized patients, increasing according to the degree of care intensity. Patients who died from COVID-19 were characterized by a mean LUS score of 11 at presentation to the emergency department. An LUS score of >7.5 was found to indicate a sensitivity of 83% and a specificity of 89% for 30-day mortality in COVID-19 patients. The use of LUS seems to be an optimal first level method for pneumonia detection and risk stratification in patients with suspected SARS-CoV-2 infection.

Keywords: COVID-19; SARS-CoV-2; infection; lung; pneumonia; ultrasound.

PubMed Disclaimer

Conflict of interest statement

The authors declare they have no conflict of interest.

Figures

Figure 1
Figure 1
The sum of the number of the 12 examined lung fields provided a final result (LUS score); the LUS score therefore ranged from 0 to 36. The patient was preferentially examined in the sitting position; in case of forced supine position, posterior scans were performed by rolling the patient on their side.
Figure 2
Figure 2
Flowchart scheme with number of patients included and excluded in the study.
Figure 3
Figure 3
Correlation between LUS score and delta (A–a) in COVID-19 patients. The data show a statistically significant direct correlation.
Figure 4
Figure 4
Correlation between LUS score and P/F ratio in COVID-19 patients. The data show a statistically significant inverse correlation.
Figure 5
Figure 5
Correlation between LUS score and delta (A-a) increase in COVID-19 patients. The data show a statistically significant direct correlation.
Figure 6
Figure 6
Comparison of ROC curves of LUS score, P/F ratio, delta (A–a), and delta (A–a) increase for the 30-day mortality of COVID-19 patients.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Xing C., Li Q., Du H., Kang W., Lian J., Yuan L. Lung ultrasound findings in patients with COVID-19 pneumonia. Crit. Care. 2020;24:174. doi: 10.1186/s13054-020-02876-9. - DOI - PMC - PubMed
    1. Volpicelli G., Gargani L. Sonographic signs and patterns of COVID-19 pneumonia. Ultrasound J. 2020;12:22. doi: 10.1186/s13089-020-00171-w. - DOI - PMC - PubMed
    1. Soldati G., Smargiassi A., Inchingolo R., Buonsenso D., Perrone T., Briganti D.F., Perlini S., Torri E., Mariani A., Mossolani E.E., et al. On Lung Ultrasound Patterns Specificity in the Management of COVID-19 Patients. J. Ultrasound Med. 2020;39:2283–2284. doi: 10.1002/jum.15326. - DOI - PMC - PubMed
    1. Sofia S., Boccatonda A., Montanari M., Spampinato M., D’ardes D., Cocco G., Accogli E., Cipollone F., Schiavone C. Thoracic ultrasound and SARS-COVID-19: A pictorial essay. J. Ultrasound. 2020;23:217–221. doi: 10.1007/s40477-020-00458-7. - DOI - PMC - PubMed
    1. Guarracino F., Vetrugno L., Forfori F., Corradi F., Orso D., Bertini P., Ortalda A., Federici N., Copetti R., Bove T. Lung, Heart, Vascular, and Diaphragm Ultrasound Examination of COVID-19 Patients: A Comprehensive Approach. J. Cardiothorac. Vasc. Anesth. 2020;35:1866–1874. doi: 10.1053/j.jvca.2020.06.013. - DOI - PMC - PubMed

LinkOut - more resources