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Peixoto AO, Costa RM, Uzun R, Fraga AMA, Ribeiro JD, Marson FAL. Applicability of lung ultrasound in COVID-19 diagnosis and evaluation of the disease progression: A systematic review. Pulmonology 2021; 27:529-562. [PMID: 33931378 PMCID: PMC7983424 DOI: 10.1016/j.pulmoe.2021.02.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 01/29/2021] [Accepted: 02/16/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic originated in China and within about 4 months affected individuals all over the world. One of the limitations to the management of the COVID-19 is the diagnostic imaging to evaluate lung impairment and the patients' clinical evolution, mainly, in more severe cases that require admission into the intensive care unit. Among image examinations, lung ultrasound (LU) might be a useful tool to employ in the treatment of such patients. METHODS A survey was carried out on PubMed to locate studies using the descriptors: ((Lung ultrasound OR ultrasound OR lung ultrasonography OR lung US) AND (coronavirus disease-19 OR coronavirus disease OR corona virus OR COVID-19 OR COVID19 OR SARS-CoV-2)). The period covered by the search was November 2019 to October 2020 and the papers selected reported LU in COVID-19. RESULTS Forty-three studies were selected to produce this systematic review. The main LU findings referred to the presence of focal, multifocal and/or confluent B lines and the presence of pleural irregularities. CONCLUSIONS The use of LU in the evaluation of patients with COVID-19 should be encouraged due to its intrinsic characteristics; a low cost, radiation free, practical method, with easy to sanitize equipment, which facilitates structural evaluation of lung damage caused by SARS-CoV-2. With the increase in the number of studies and the use of ultrasound scans, LU has been shown as a useful tool to evaluate progression, therapeutic response and follow-up of pulmonary disease in the patients with COVID-19.
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Affiliation(s)
- A O Peixoto
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, São Paulo, CEP: 13083-887, Brazil.
| | - R M Costa
- Anesthesiology Service, Pitangueiras Hospital, Sobam Group - United Health Group, Pitangueiras, 651, Vila Vianelo, Jundiaí, São Paulo, CEP: 13206-716, Brazil; Anesthesiology Service, Hospital Sobrapar - Brazilian Society of Craniofacial Rehabilitation Research and Assistance, Av. Adolfo Lutz, 100, Jardim Santa Genebra, Campinas, São Paulo, CEP: 13084-880, Brazil.
| | - R Uzun
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, São Paulo, CEP: 13083-887, Brazil.
| | - A M A Fraga
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, São Paulo, CEP: 13083-887, Brazil.
| | - J D Ribeiro
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, São Paulo, CEP: 13083-887, Brazil.
| | - F A L Marson
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, São Paulo, CEP: 13083-887, Brazil; Laboratory of Medical Genetics and Genome Medicine, Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas, Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, São Paulo, CEP: 13083-887, Brazil; Laboratory of Human and Medical Genetics, São Francisco University, Avenida São Francisco de Assis, 218, Jardim São José, Bragança Paulista, São Paulo, CEP: 12916-900, Brazil.
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Musa MJ, Yousef M, Adam M, Wagealla A, Boshara L, Belal D, Abukonna A. The Role of Lung Ultrasound Before and During the COVID-19 Pandemic: A review article. Curr Med Imaging 2021; 18:593-603. [PMID: 34620067 DOI: 10.2174/1573405617666211006122842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/31/2021] [Accepted: 08/20/2021] [Indexed: 11/22/2022]
Abstract
Lung ultrasound [LUS] has evolved considerably over the last years. The aim of the current review is to conduct a systematic review reported from a number of studies to show the usefulness of [LUS] and point of care ultrasound for diagnosing COVID-19. A systematic search of electronic data was conducted including the national library of medicine, and the national institute of medicine, PubMed Central [PMC] to identify the articles depended on [LUS] to monitor COVID-19. This review highlights the ultrasound findings reported in articles before the pandemic [11], clinical articles before COVID-19 [14], review studies during the pandemic [27], clinical cases during the pandemic [5] and other varying aims articles. The reviewed studies revealed that ultrasound findings can be used to help in the detection and staging of the disease. The common patterns observed included irregular and thickened A-lines, multiple B-lines ranging from focal to diffuse interstitial consolidation, and pleural effusion. Sub-plural consolidation is found to be associated with the progression of the disease and its complications. Pneumothorax was not recorded for COVID-19 patients. Further improvement in the diagnostic performance of [LUS] for COVID-19 patients can be achieved by using elastography, contrast-enhanced ultrasound, and power Doppler imaging.
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Affiliation(s)
- Mustafa J Musa
- University of Jeddah, College of Applied Medical Sciences, Department of Applied Radiologic Technology, Jeddah . Saudi Arabia
| | - Mohamed Yousef
- Radiologic Sciences Program, Batterjee Medical College, Jeddah . Saudi Arabia
| | - Mohammed Adam
- King Khalid University, College of Medical Applied Sciences, Department of Diagnostic Radiology Sciences, Abha . Saudi Arabia
| | - Awadalla Wagealla
- Radiological Sciences Department, Al-Ghad International College for Applied Medical Science, Abha. Saudi Arabia
| | - Lubna Boshara
- University of Jeddah, College of Applied Medical Sciences, Department of Applied Radiologic Technology, Jeddah . Saudi Arabia
| | - Dalia Belal
- University of Jeddah, College of Applied Medical Sciences, Department of Applied Radiologic Technology, Jeddah. Saudi Arabia
| | - Ahmed Abukonna
- Radiological Sciences Department, Al-Ghad International College for Applied Medical Science, Abha. Sudan
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Kalagara H, Manson W, Townsley MM. Point-of-Care Ultrasound (POCUS) Training for Anesthesiologists: Is it Time to Embrace and Attain Competency? J Cardiothorac Vasc Anesth 2021; 36:30-32. [PMID: 34521580 DOI: 10.1053/j.jvca.2021.08.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 08/09/2021] [Indexed: 12/25/2022]
Affiliation(s)
- Hari Kalagara
- Department of Anesthesiology, Mayo Clinic, Jacksonville, FL
| | - William Manson
- Department of Anesthesiology, University of Virginia Health, Charlottesville, VA
| | - Matthew M Townsley
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL.
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Boero E, Schreiber A, Rovida S, Vetrugno L, Blaivas M. The role of lung ultrasonography in COVID-19 disease management. J Am Coll Emerg Physicians Open 2020; 1:1357-1363. [PMID: 32838389 PMCID: PMC7404352 DOI: 10.1002/emp2.12194] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/21/2020] [Accepted: 06/25/2020] [Indexed: 12/13/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) has created unprecedented disruption for global healthcare systems. Offices and emergency departments (EDs) were the first responders to the pandemic, followed by medical wards and intensive care unit (ICUs). Worldwide efforts sprouted to coordinate proper response by increasing surge capacity and optimizing diagnosis and containment. Within the complex scenario of the outbreak, the medical community shared scientific research and implemented best-guess imaging strategies in order to save time and additional staff exposures. Early publications showed agreement between chest computed tomography (CT) and lung sonography: widespread ground-glass findings resembling acute respiratory distress syndrome (ARDS) on CT of COVID-19 patients matched lung ultrasound signs and patterns. Well-established accuracy of bedside sonography for lung conditions and its advantages (such as no ionizing radiation; low-cost, real-time bedside imaging; and easier disinfection steps) prompted a wider adoption of lung ultrasound for daily assessment and monitoring of COVID-19 patients. Growing literature, webinars, online materials, and international networks are promoting lung ultrasound for the same purpose. We propose 11 lung ultrasound roles for different medical settings during the pandemic, starting from the out-of-hospital setting, where lung ultrasound has ergonomic and infection control advantages. Then we describe how medical wards and ICUs can safely integrate lung ultrasound into COVID-19 care pathways. Finally, we present outpatient use of lung ultrasound to aid follow-up of positive case contacts and of those discharged from the hospital.
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Affiliation(s)
- Enrico Boero
- Anesthesia and Intensive Care UnitSan Giovanni Bosco HospitalTurinItaly
| | - Annia Schreiber
- Interdepartmental Division of Critical Care MedicineUnity Health Toronto (St. Michael's Hospital)TorontoCanada
| | - Serena Rovida
- Department of Anesthesia and Intensive Care UnitSaint Bartholomew's HospitalBarts NHS TrustLondonUK
| | - Luigi Vetrugno
- Anesthesia and Intensive Care Unit, Department of MedicineUniversity of UdineUdineItaly
| | - Michael Blaivas
- Department of Medicine. Department of Emergency MedicineSt. Francis Hospital, University of South Carolina School of MedicineColumbusGeorgiaUSA
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Augoustides JG. Cardiopulmonary Resuscitation During the Coronavirus Crisis: Important Updates for the Cardiothoracic and Vascular Anesthesia Community. J Cardiothorac Vasc Anesth 2020; 34:2312-2314. [PMID: 32434725 PMCID: PMC7187853 DOI: 10.1053/j.jvca.2020.04.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/18/2020] [Indexed: 12/20/2022]
Affiliation(s)
- John G Augoustides
- Cardiovascular and Thoracic Section Department of Anesthesiology and Critical Care Perelman School of Medicine University of Pennsylvania Philadelphia, PA.
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Neves SE, Fatima H, Walsh DP, Mahmood F, Chaudhary O, Matyal R. Role of Ultrasound-Guided Evaluation of Dyspnea in the Coronavirus Disease 2019 Pandemic. J Cardiothorac Vasc Anesth 2020; 34:3197-3202. [PMID: 32737001 PMCID: PMC7340068 DOI: 10.1053/j.jvca.2020.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Sara E Neves
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Huma Fatima
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Daniel P Walsh
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Feroze Mahmood
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Omar Chaudhary
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Robina Matyal
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
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Vetrugno L, Bove T, Orso D, Barbariol F, Bassi F, Boero E, Ferrari G, Kong R. B lines in COVID-19: "Unspecificity" is not "meaningless". Echocardiography 2020; 37:1140-1141. [PMID: 32557817 PMCID: PMC7323401 DOI: 10.1111/echo.14768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Luigi Vetrugno
- Department of Medicine, Anesthesia and Intensive Care Clinic, University of Udine, Udine, Italy.,Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy
| | - Tiziana Bove
- Department of Medicine, Anesthesia and Intensive Care Clinic, University of Udine, Udine, Italy.,Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy
| | - Daniele Orso
- Department of Medicine, Anesthesia and Intensive Care Clinic, University of Udine, Udine, Italy
| | - Federico Barbariol
- Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy
| | - Flavio Bassi
- Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy
| | - Enrico Boero
- Anesthesia and Intensive Care, San Giovanni Bosco Hospital, Torino, Italy
| | - Giovanni Ferrari
- SC Pneumologia ad Indirizzo Semi Intensivo, Azienda Ospedaliera Ordine Mauriziano, Torino, Italy
| | - Robert Kong
- Cardiac Anaesthesia & Intensive Care, Brighton & Sussex University Hospital, Brighton, UK
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Cavarretta E, Biondi-Zoccai G, Frati G, Versaci F. Veneto's Successful Lesson for a World Shocked by COVID-19: Think Globally and Act Locally. J Cardiothorac Vasc Anesth 2020; 34:2346-2348. [PMID: 32624433 PMCID: PMC7296310 DOI: 10.1053/j.jvca.2020.06.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome Latina, Italy; Mediterranea Cardiocentro, Napoli, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome Latina, Italy; Mediterranea Cardiocentro, Napoli, Italy
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome Latina, Italy; IRCCS NEUROMED, Pozzilli (IS), Italy
| | - Francesco Versaci
- Unità Operativa Complessa di UTIC Emodinamica e Cardiologia, Ospedale Santa Maria Goretti, Latina, Italy
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