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Topical Collection "Current Advances in Lung Ultrasound for COVID-19"

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A topical collection in Journal of Clinical Medicine (ISSN 2077-0383). This collection belongs to the section "Epidemiology & Public Health".

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Dr. Danilo Buonsenso

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Collection Editor

1. Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
2. Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "A. Gemelli", 00168 Roma, Italy
Interests: pediatrics; Long COVID; global health
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Dear Colleagues,

2020 has been a unique year for medicine. This pandemic is still having a profound impact on human lives, clinical practice and research. However, SARS-CoV-2 gave us the opportunity to reconsider and improve the way we see medicine. The pandemic accelerated progresses in several fields, from immunology and vaccinology, to telemedicine and artificial intelligence. In each of these aspects, lung ultrasound played a significant role.

During the first months of the pandemic, clinicians and researchers of the Italian Academy of Thoracic Ultrasound (Accademia di Ecografia Toracica—ADET) had already highlighted the potential role of lung ultrasound in the diagnosis and monitoring of COVID-19 pneumonia. Later on, a proposal for an international standardization of the procedure and its prognostic role was clearly demonstrated by the same group. Artificial Intelligence platforms have been developed. Early observations have been confirmed worldwide, including in children.

With this Topical Collection, we call International clinicians and researchers to share their experiences, perspectives, reviews and original papers assessing the role of lung ultrasound in adults and children with COVID-19. We are also interested in viewpoints and personal experiences highlighting how lung ultrasound impacted your clinical practice, experiences, teaching programs, professional relationships.

Dr. Danilo Buonsenso
Collection Editor

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Keywords

lung ultrasound
COVID-19
SARS-CoV-2
Children
multisystem inflammatory syndrome
adults

Published Papers (9 papers)

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2022

Jump to: 2021

Open AccessCase Report

Utility and Limits of Lung Ultrasound in Childhood Pulmonary Tuberculosis: Lessons from a Case Series and Literature Review

Daniele Guerino Biasucci

Luigi Vetrugno

and

Danilo Buonsenso

J. Clin. Med. 2022, 11(19), 5714; https://doi.org/10.3390/jcm11195714 - 27 Sep 2022

Viewed by 777

Abstract

Childhood pulmonary tuberculosis (PTB) diagnosis is often a challenge that requires a combination of history, clinical, radiological, immunological and microbiological findings. Radiological diagnosis is based today on the use of chest X-ray and chest CT that, in addition to being radio-invasive tools for children, are often not available in countries with low-resources. A non-invasive, easily usable and reproducible, low-cost diagnostic tool as LUS would therefore be useful to use to support the diagnosis of childhood PTB. Data on the use of LUS for the diagnosis and follow-up of childhood PTB are limited and in some respects contradictory. To help better define the potential role of LUS we have described the pros and cons of lung ultrasound method through a brief review of the studies in the literature and reporting some case series in which we describe clinical, laboratory, radiological results as well as detailed lung ultrasound findings of four children/adolescents with PTB. Full article

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Open AccessArticle

Are Lung Ultrasound Features More Severe in Children Diagnosed with Bronchiolitis after the COVID-19 Lockdown Period?

and

J. Clin. Med. 2022, 11(18), 5294; https://doi.org/10.3390/jcm11185294 - 08 Sep 2022

Viewed by 646

Abstract

The non-pharmacological measures implemented during the SARS-CoV-2 pandemic disrupted the usual bronchiolitis seasonality. Some authors have speculated that, after the lock down period, there would be an increase in the number and severity of respiratory infections due to the re-introduction of respiratory viruses. We collected clinical, microbiological and lung ultrasound data using the classification of the Italian Society of Thoracic Ultrasound (ADET) in children with bronchiolitis during the pandemic compared to the pre-pandemic period, with the aim of assessing whether the epidemic of bronchiolitis during the pandemic was characterized by a more severe lung involvement documented by lung ultrasound. We enrolled 108 children with bronchiolitis (52 pre-pandemic and 56 COVID-19 period), with a median age of 1.74 months (interquartile range, IQR 1–3.68) and 39.8% were females. Rhinovirus detection and high-flow nasal cannula usage were both increased during the COVID-19 period, although overall need of hospitalization and pediatric intensive care unit admissions did not change during the two periods. Lung ultrasound scores were similar in the two cohorts evaluated. Conclusions: our study suggests that, despite changes in microbiology and treatments performed, lung ultrasound severity scores were similar, suggesting that that bronchiolitis during the pandemic period was no more severe than pre-pandemic period, despite children diagnosed during the pandemic had a higher, but it was not statistically significant, probably, due to small sample size, probability of being admitted. Full article

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Open AccessReview

Current Advances in Lung Ultrasound in COVID-19 Critically Ill Patients: A Narrative Review

Minh Pierre Lê

Mathieu Jozwiak

and

Driss Laghlam

J. Clin. Med. 2022, 11(17), 5001; https://doi.org/10.3390/jcm11175001 - 26 Aug 2022

Viewed by 1075

Abstract

Lung ultrasound (LUS) has a relatively recent democratization due to the better availability and training of physicians, especially in intensive care units. LUS is a relatively cheap and easy-to-learn and -use bedside technique that evaluates pulmonary morphology when using simple algorithms. During the global COVID-19 pandemic, LUS was found to be an accurate tool to quickly diagnose, triage and monitor patients with COVID-19 pneumonia. This paper aims to provide a comprehensive review of LUS use during the COVID-19 pandemic. The first section of our work defines the technique, the practical approach and the semeiotic signs of LUS examination. The second section exposed the COVID-19 pattern in LUS examination and the difference between the differential diagnosis patterns and the well-correlation found with computer tomography scan findings. In the third section, we described the utility of LUS in the management of COVID-19 patients, allowing an early diagnosis and triage in the emergency department, as the monitoring of pneumonia course (pneumonia progression, alveolar recruitment, mechanical ventilation weaning) and detection of secondary complications (pneumothorax, superinfection). Moreover, we describe the usefulness of LUS as a marker of the prognosis of COVID-19 pneumonia in the fourth section. Finally, the 5th part is focused on describing the interest of the LUS, as a non-ionized technique, in the management of pregnant COVID-19 women. Full article

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Open AccessEditorial

Lung Ultrasound in Adults and Children with COVID-19: From First Discoveries to Recent Advances

Danilo Buonsenso

and

Luigi Vetrugno

J. Clin. Med. 2022, 11(15), 4340; https://doi.org/10.3390/jcm11154340 - 26 Jul 2022

Viewed by 939

Abstract

During this pandemic, the lung ultrasound (LUS) imaging modality has shown promising results as a diagnostic, prognostic and monitoring tool for COVID-19 patients [...] Full article

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Open AccessArticle

Prognostic Role of Lung Ultrasound in Children with Bronchiolitis: Multicentric Prospective Study

Tiziana Virginia Sciacca

Rosa Morello

Francesco Tursi

Gino Soldati

and Ecobron Group

J. Clin. Med. 2022, 11(14), 4233; https://doi.org/10.3390/jcm11144233 - 21 Jul 2022

Cited by 1 | Viewed by 1339

Abstract

There is increasing recognition of the role of lung ultrasound (LUS) to assess bronchiolitis severity in children. However, available studies are limited to small, single-center cohorts. We aimed to assess a qualitative and quantitative LUS protocol to evaluate the course of bronchiolitis at diagnosis and during follow-up. This is a prospective, multicenter study. Children with bronchiolitis were stratified according to clinical severity and underwent four LUS evaluations at set intervals. LUS was classified according to four models: (1) positive/negative; (2) main LUS pattern (normal/interstitial/consolidative/mixed) (3) LUS score; (4) LUS score with cutoff. Two hundred and thirty-three children were enrolled. The baseline LUS was significantly associated with bronchiolitis severity, using both the qualitative (positive/negative LUS p < 0.001; consolidated/normal LUS pattern or mixed/normal LUS p < 0.001) and quantitative models (cutoff score > 9 p < 0.001; LUS mean score p < 0.001). During follow-up, all LUS results according to all LUS models improved (p < 0.001). Better cut off value was declared at a value of >9 points. Conclusions: Our study supports the role of a comprehensive qualitative and quantitative LUS protocol for the identification of severe cases of bronchiolitis and provides data on the evolution of lung aeration during follow-up. Full article

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Open AccessArticle

The Assessment of COVID-19 Pneumonia in Neonates: Observed by Lung Ultrasound Technique and Correlated with Biomarkers and Symptoms

Emil Robert Stoicescu

Diana Luminita Manolescu

and

J. Clin. Med. 2022, 11(12), 3555; https://doi.org/10.3390/jcm11123555 - 20 Jun 2022

Cited by 3 | Viewed by 920

Abstract

Newborns infected with SARS-CoV2 infection develop different symptoms in comparison with adults, but one thing is clear: some of the most common manifestations include cough and other respiratory symptoms that need to be evaluated. In these cases, lung ultrasound is a useful imaging technique that can evaluate the newborns’ lung damage caused by COVID-19 pneumonia and can be used for the surveillance of the patients as well, being non-irradiating and easy to use. Nineteen neonates who were confirmed as having SARS-CoV2 infection were investigated using this imaging tool, and the results were compared and correlated with their symptoms and biomarkers. The mean of LUSS was 12.21 ± 3.56 (S.D), while the 95% CI for the arithmetic mean was 10.49–13.93. The difference of an independent t-test between the LUSS for the patient who presented cough and the LUSS for the patient without cough was −4.48 with an associated p-value of p = 0.02. The Pearson’s correlation coefficient r = 0.89 (p = 0.03, 95% CI 0.0642 to 0.993) between the LUSS and IL-6 level showed a positive strong correlation. This reliable correlation between lung ultrasound score and inflammatory markers suggests that LUS could be used for monitoring inflammatory lung diseases in the future. Full article

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Open AccessArticle

The Role of Lung Ultrasound in Diagnosing COVID-19-Related Multisystemic Inflammatory Disease: A Preliminary Experience

Maria Alessia Mesturino

and

J. Clin. Med. 2022, 11(1), 234; https://doi.org/10.3390/jcm11010234 - 01 Jan 2022

Cited by 6 | Viewed by 979

Abstract

Background: To date, there are no data regarding the systematic application of Point-of-Care Lung Ultrasound (PoC-LUS) in children with Multisystem Inflammatory Syndrome in Children (MIS-C). The main aim of this study is to show the role of Point-of-Care Lung Ultrasound as an additional aid in the diagnosis of COVID-19-related Multisystem Inflammatory Syndrome in Children (MIS-C). Methods: Between April 2020 and April 2021, patients aged 0–18 years referred to our emergency department for fever, and later hospitalized without a specific diagnosis, underwent PoC-LUS. Ultrasound images of patients with a final diagnosis of MIS-C were retrospectively evaluated. Results: Ten patients were enrolled. All were described to have pleural irregularities and B-lines. In particular: 8/10 children presented with isolated B-lines in at least half of the lung areas of interest; 8/10 presented with multiple B-lines and 3/8 had them in at least 50% of lung areas; 5/10 had a white lung appearance in at least one lung area and 1/5 had them in half of the areas of interest. Pleural effusion was described in 9/10. Conclusions: During the ongoing COVID-19 pandemic, we suggest performing PoC-LUS in febrile patients with high levels of inflammatory indices and clinical suspicion of MIS-C, or without a certain diagnosis; the finding of many B-lines and pleural effusion would support the diagnosis of a systemic inflammatory disease. Full article

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2021

Jump to: 2022

Open AccessArticle

Prediction Accuracy of Serial Lung Ultrasound in COVID-19 Hospitalized Patients (Pred-Echovid Study)

Juan Torres-Macho

Marcos Sánchez-Fernández

Irene Arnanz-González

Yale Tung-Chen

Ana Isabel Franco-Moreno

Mercedes Duffort-Falcó

Luis Beltrán-Romero

Santiago Rodríguez-Suaréz

Máximo Bernabeu-Wittel

Elena Urbano

Manuel Méndez-Bailon

Fernando Roque-Rojas

Elena García-Guijarro

and

Gonzalo García-Casasola

J. Clin. Med. 2021, 10(21), 4818; https://doi.org/10.3390/jcm10214818 - 20 Oct 2021

Cited by 10 | Viewed by 1400

Abstract

The value of serial lung ultrasound (LUS) in patients with COVID-19 is not well defined. In this multicenter prospective observational study, we aimed to assess the prognostic accuracy of serial LUS in patients admitted to hospital due to COVID-19. The serial LUS protocol included two examinations (0–48 h and 72–96 h after admission) using a 10-zones sequence, and a 0 to 5 severity score. Primary combined endpoint was death or the need for invasive mechanical ventilation. Calibration (Hosmer–Lemeshow test and calibration curves), and discrimination power (area under the ROC curve) of both ultrasound exams (SCORE1 and 2), and their difference (DIFFERENTIAL-SCORE) were performed. A total of 469 patients (54.2% women, median age 60 years) were included. The primary endpoint occurred in 51 patients (10.9%). Probability risk tertiles of SCORE1 and SCORE2 (0–11 points, 12–24 points, and ≥25 points) obtained a high calibration. SCORE-2 showed a higher discrimination power than SCORE-1 (AUC 0.72 (0.58–0.85) vs. 0.61 (0.52–0.7)). The DIFFERENTIAL-SCORE showed a higher discrimination power than SCORE-1 and SCORE-2 (AUC 0.78 (0.66–0.9)). An algorithm for clinical decision-making is proposed. Serial lung ultrasound performing two examinations during the first days of hospitalization is an accurate strategy for predicting clinical deterioration of patients with COVID-19. Full article

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Open AccessArticle

Lung Ultrasound Examination in Patients with SARS-CoV-2 Infection: Multicenter Study

Aleksandra Oraczewska

and

J. Clin. Med. 2021, 10(15), 3255; https://doi.org/10.3390/jcm10153255 - 23 Jul 2021

Cited by 8 | Viewed by 2340

Abstract

Background: The COVID-19 pandemic has, by necessity, contributed to rapid advancements in medicine. Owing to the necessity of following strict anti-epidemic sanitary measures when taking care of infected patients, the accessibility of standard diagnostic methods may be limited. Consequently, the significance and potential of bedside diagnostic modalities increase, including lung ultrasound (LUS). Method: Multicenter registry study involving adult patients with confirmed COVID-19, for whom LUS was performed. Results: A total of 228 patients (61% males) qualified for the study. The average age was 60 years (±14), 40% were older than 65 years of age. In 130 from 173 hospitalized patients, HRCT (high-resolution computed tomography) was performed. In 80% of patients, LUS findings indicated interstitial pneumonia. In hospitalized patients multifocally located single B-lines, symmetrical B-lines, and areas of white lung were significantly more frequent as compared to ambulatory patients. LUS findings, both those indicating interstitial syndrome and consolidations, were positively correlated with HRCT images. As compared to HRCT, the sensitivity and specificity of LUS in detecting interstitial pneumonia were 97% and 100%, respectively. Conclusions: As compared to HRCT, LUS is characterized by a very high sensitivity and specificity in detecting interstitial pneumonia in COVID-19 patients. Potentially, LUS can be a particularly useful diagnostic modality for COVID-19 patients pneumonia. Full article

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