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Lung ultrasound for early diagnosis and severity assessment of pneumonia in patients with coronavirus disease 2019

Korean Journal of Internal Medicine 2020년 35권 4호 p.771 ~ 781
조영재, 송경호, 이용희, Yoon Joo-Heung, 박지영, 정종탁, 임성윤, 이현주, 윤호일, 박경운, 김홍빈, 김의석,
소속 상세정보
조영재 ( Cho Young-Jae ) - Seoul National University Bundang Hospital Department of Internal Medicine
송경호 ( Song Kyoung-Ho ) - Seoul National University Bundang Hospital Department of Internal Medicine
이용희 ( Lee Yung-Hee ) - Seoul National University Bundang Hospital Department of Internal Medicine
 ( Yoon Joo-Heung ) - University of Pittsburgh Medical Center Department of Medicine
박지영 ( Park Ji-Young ) - Chung-Ang University Hospital Department of Pediatrics
정종탁 ( Jung Jong-Tak ) - Seoul National University Bundang Hospital Department of Internal Medicine
임성윤 ( Lim Sung-yoon ) - Seoul National University Bundang Hospital Department of Internal Medicine
이현주 ( Lee Hyun-Ju ) - Seoul National University Bundang Hospital Department of Pediatrics
윤호일 ( Yoon Ho-Il ) - Seoul National University Bundang Hospital Department of Internal Medicine
박경운 ( Park Kyoung-Un ) - Seoul National University Bundang Hospital Department of Laboratory Medicine
김홍빈 ( Kim Hong-Bin ) - Seoul National University Bundang Hospital Department of Internal Medicine
김의석 ( Kim Eu-Suk ) - Seoul National University Bundang Hospital Department of Internal Medicine

Abstract


Background/Aims: Current evidence supports lung ultrasound as a point-ofcare alternative diagnostic tool for various respiratory diseases. We sought to determine the utility of lung ultrasound for early detection of pneumonia and for assessment of respiratory failure among patients with coronavirus disease 2019 (COVID-19).

Methods: Six patients with confirmed COVID-19 by reverse transcription-polymerase chain reaction were enrolled. All had undergone chest X-ray and chest computed tomography (CT) on the day of admission and underwent multiple point-of-care lung ultrasound scans over the course of their hospitalization.

Results: Lung ultrasound detected early abnormal findings of representative B-lines in a patient with a normal chest X-ray, corresponding to ground-glass opacities on the chest CT scan. The ultrasound findings improved as her clinical condition improved and her viral load decreased. In another minimally symptomatic patient without significant chest X-ray findings, the ultrasound showed B-lines, an early sign of pneumonia before abnormalities were detected on the chest CT scan. In two critically ill patients, ultrasound was performed to assess for evaluation of disease severity. In both patients, the clinicians conducted emergency rapid sequence intubation based on the ultrasound findings without awaiting the laboratory results and radiological reports. In two children, ultrasound was used to assess the improvement in their pneumonia, thus avoiding further imaging tests such as chest CT.

Conclusions: Lung ultrasound is feasible and useful as a rapid, sensitive, and affordable point-of-care screening tool to detect pneumonia and assess the severity of respiratory failure in patients hospitalized with COVID-19.

키워드

Ultrasonography ; Pneumonia ; Respiratory insufficiency ; Severe acute respiratory syndrome coronavirus 2 ; COVID-19

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