Lung ultrasound in patients with covid-19

Abstract

COVID-19 is an infectious disease which surfaced in December 2019 (Wuhan, China) and swept across all the continents in a matter of 3 months, triggering a pandemic faced by humanity for the first time. Given the predominance of respiratory symptoms in patients, often accompanied by the development of interstitial pneumonia, and the fact that it is a highly contagious disease, it called for a prompt, reliable and safe diagnosis of pulmonary complications of the disease. In COVID-19 patients, focused lung ultrasound is superior to the classical heart or chest X-ray, and in terms of diagnostic reliability, is almost up to par to an MSCT of the thorax. This is due to the fact that inflammatory infiltrates are localized primarily basally and peripherally where they are accessible to ultrasound examinations. Regions 5 and 6 (both sides) are most commonly affected, and medical reports show a predominance of multiple B lines in 2 or more regions in combination with individual B lines. In March 2020, the Primary Respiratory Intensive Care Center at Clinical Hospital Dubrava (PRIC KBD) was founded to treat COVID-19 patients with a moderate to severe clinical picture and signs of respiratory failure. In addition to an X-ray of the heart and lungs and MSCT of the thorax, patients were diagnosed and monitored using focused lung ultrasound. Besides a good correlation with the clinical picture and degree of respiratory failure, focused lung ultrasound has shown to be favorable due to short aerosol exposure during screening, without the need to mobilize patients or use a mobile X-ray device. It has become an unrivalled replacement for the stethoscope, capable of adhering to all measures to prevent the spread of aerosols: a cordless mobile device, disinfectable, with even the ability to use only one device per patient in the intensive care unit, rendering it an important diagnostic tool in COVID-19 positive patients.