PURPOSE Lung ultrasonography (LU) is useful to assess lung lesions and variations at bedside . To investigate the results of LU in severe and critical patients with coronavirus disease 2019 (COVID-19), we performed a single-institution study to evaluate the related lung lesions and variations, and prophylactic strategies, in a large referral and treatment center .
METHODS We included 91 adult patients with severe and critical COVID-19, namely 62 males and 29 females, with an average age of 59 ± 11 years, who underwent LU . We collected the following patient information: sex, age, days in hospital, and days in ICU . In the ultrasound examinations, we recorded the presence of discrete B lines, confluent B lines, consolidation, pleural thickening, pleural effusion, and pneumothorax (PTX).
RESULTS Among the 91 severe and critical patients, 59 cases had scattered B lines, 56 cases had confluent B lines , 58 cases had alveolar-interstitial syndrome (AIS), 48 cases had lung consolidation, six cases had pleural thickening , 39 cases had pleural effusion (average depth of the pleural effusion : 1.0 ± 1.5 cm), and 20 patients developed PTX . In the Cox multivariate analysis, there were significant differences in age, hospitalization days, ICU days, and lung consolidation .
CONCLUSION Lung ultrasonography performed at the bedside can detect lung diseases, such as B lines, PTX, pulmonary edema, lung consolidation, pleural effusion, and variations of these findings . Our findings support the use of LU and measurements for estimating factors, and monitoring response to therapy in severe and critical COVID-19 patients.