Lung Ultrasound Patterns and Clinical-Laboratory Correlates during COVID-19 Pneumonia: A Retrospective Study from North East Italy

• Main Authors: Riccardo Senter, Federico Capone, Stefano Pasqualin, Lorenzo Cerruti, Leonardo Molinari, Elisa Fonte Basso, Nicolò Zanforlin, Lorenzo Previato, Alessandro Toffolon, Caterina Sensi, Gaetano Arcidiacono, Davide Gorgi, Renato Ippolito, Enrico Nessi, Pietro Pettenella, Andrea Cellini, Claudio Fossa, Eleonora Vania, Samuele Gardin, Andi Sukthi, Dora Luise, Maria Teresa Giordani, Mirko Zanatta, Sandro Savino, Vito Cianci, Andrea Sattin, Anna Maria, Andrea Vianello, Raffaele Pesavento, Sandro Giannini, Angelo Avogaro, Roberto Vettor, Gian Paolo Fadini, Alois Saller
• Format: Article
• Language: English
• Published: MDPI AG 2021-03-01
• Series: Journal of Clinical Medicine
• Subjects: COVID-19; lung ultrasound; B-lines; consolidations
• Online Access: https://www.mdpi.com/2077-0383/10/6/1288

Background and Aim. Lung ultrasound (LUS) is a convenient imaging modality in the setting of coronavirus disease-19 (COVID-19) because it is easily available, can be performed bedside and repeated over time. We herein examined LUS patterns in relation to disease severity and disease stage among patients with COVID-19 pneumonia. Methods. We performed a retrospective case series analysis of patients with confirmed SARS-CoV-2 infection who were admitted to the hospital because of pneumonia. We recorded history, clinical parameters and medications. LUS was performed and scored in a standardized fashion by experienced operators, with evaluation of up to 12 lung fields, reporting especially on B-lines and consolidations. Results. We included 96 patients, 58.3% men, with a mean age of 65.9 years. Patients with a high-risk quick COVID-19 severity index (qCSI) were older and had worse outcomes, especially for the need for high-flow oxygen. B-lines and consolidations were located mainly in the lower posterior lung fields. LUS patterns for B-lines and consolidations were significantly worse in all lung fields among patients with high versus low qCSI. B-lines and consolidations were worse in the intermediate disease stage, from day 7 to 13 after onset of symptoms. While consolidations correlated more with inflammatory biomarkers, B-lines correlated more with end-organ damage, including extrapulmonary involvement. Conclusions. LUS patterns provide a comprehensive evaluation of patients with COVID-19 pneumonia that correlated with severity and dynamically reflect disease stage. LUS patterns may reflect different pathophysiological processes related to inflammation or tissue damage; consolidations may represent a more specific sign of localized disease, whereas B-lines seem to be also dependent upon generalized illness due to SARS-CoV-2 infection.