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Observational Study
. 2022 Nov;17(8):2261-2268.
doi: 10.1007/s11739-022-03084-9. Epub 2022 Sep 14.

Lung ultrasound in the follow-up of severe COVID-19 pneumonia: six months evaluation and comparison with CT

Giulia Russo  1   2 , Nicola Flor  3 , Francesco Casella  4 , Sonia Ippolito  3 , Federica Leidi  4 , Giovanni Casazza  5 , Dejan Radovanovic  6 , Federico Vezzulli  4 , Pierachille Santus  6 , Chiara Cogliati  4
Affiliations
Observational Study

Lung ultrasound in the follow-up of severe COVID-19 pneumonia: six months evaluation and comparison with CT

Giulia Russo et al. Intern Emerg Med. 2022 Nov.

Abstract

While lung ultrasonography (LUS) proved to be a useful diagnostic and prognostic tool in acute phase of COVID 19 pneumonia, its role in detecting long-term pulmonary sequelae has yet to be explored. In our prospective observational study we assessed the potential of LUS in detecting the presence of computed tomography (CT) fibrotic-like changes after 6 months from COVID-19 pneumonia. Patients who were discharged with a diagnosis of severe COVID-19 pneumonia were enrolled. After 6 months from hospital discharge they underwent LUS, chest CT scan and pulmonary function tests. A logistic regression analysis was performed to assess the association between presence of symptoms, LUS score and diffusing capacity for carbon monoxide (DLCO) at 6-month after hospital discharge and CT scan fibrotic-like changes. A second logistic model was performed to assess the value of some predefined baseline factors (age, sex, worst PaO2/FiO2, ventilator support, worst CRP value, worst D-dimer value and worst LUS score during hospitalization) to predict fibrotic-like changes on 6-month CT scan. Seventy-four patients were enrolled in the study. Twenty-four (32%) showed lung abnormalities suitable for fibrotic-like changes. At multivariate logistic regression analysis LUS score after 6 months from acute disease was significantly associated with fibrotic-like pattern on CT scan. The second logistic model showed that D-dimer value was the only baseline predictive variable of fibrotic-like changes at multivariate analysis. LUS performed after 6 months from severe COVID-19 pneumonia may be a promising tool for detection and follow-up of pulmonary fibrotic sequelae.

Keywords: COVID-19 pneumonia; Computed tomography; Lung ultrasound; Pulmonary fibrosis; Ultrasonography.

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Conflict of interest statement

All authors declare that they have no conflicts of interest. Conflict of interest disclosure forms for each author are submitted separately as a single file.

Figures

Fig. 1
Fig. 1
Examples of LUS findings at 6 months after Covid-19 pneumonia. a Interstitial pattern with separated B-lines, LUS score 1. b Interstitial pattern with confluent B-lines, LUS score 2. c Image blow-up for better appreciation of the irregular/fragmented pleural line. d Sub-centimetric pleural nodule, irregular pleural line
Fig. 2
Fig. 2
ROC curve model: LUS score accuracy for detecting patients with 6-month fibrotic-like changes on CT scan
See this image and copyright information in PMC

Comment in

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