Corona Virus

Findings of lung ultrasonography of novel corona virus pneumonia during the 2019–2020 epidemic

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features of nCoV
We performed lung ultrasonography on 20 patients with COVID-19 using a 12-zone [3].

Characteristic findings included the following:

Thickening of the line with pleural line irregularity;

B lines in a variety of patterns including , multifocal, and ;

Consolidations in a variety of patterns including multifocal small, non-translobar, and translobar with occasional mobile air ;

Appearance of A lines during recovery phase;

Pleural effusions are uncommon.

The observed patterns occurred across a continuum from mild pattern, to severe bilateral interstitial pattern, to lung consolidation. Table 1 summarizes typical lung ultrasonography finds in patients with COVID-19 respiratory disease in comparison with chest CT findings. Typical lung ultrasonography images are shown in the supplementary material.

The findings of lung ultrasonography features of SARS-CoV-2 pneumonia/ARDS are related to the stage of disease, the severity of lung injury, and . The predominant pattern is of varying degrees of interstitial and alveolar consolidation, the degree of which is correlated with the severity of the lung injury. A recognized limitation of lung ultrasonography is that it cannot detect lesions that are deep within the lung, as aerated lung blocks transmission of ultrasonography, i.e., the abnormality must extend to the pleural surface to be visible with on ultrasonography examination. Chest CT is required to detect pneumonia that does not extend to the pleural surface.

Based upon our experience, we consider that lung ultrasonography has major utility for management of COVID-19 with respiratory involvement due to its safety, repeatability, absence of radiation, low cost and point of care use; chest CT may be reserved for cases where lung ultrasonography is not sufficient to answer the clinical question. We find there is utility of lung ultrasonography for rapid assessment of the severity of SARS-CoV-2 pneumonia/ARDS at presentation, to track the evolution of disease, to monitor lung recruitment , to guide response to prone position, the management of therapy, and for making decisions related to weaning the patient form support.

Department of Critical Care Medicine, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, 410008 Hunan Province China
2Department of Critical Care Medicine, Peking Union Medical College Hospital, Tsinghua University, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, 100730 Beijing China
Xiao-Ting Wang,