Evolution of Pulmonary Ultrasound in Patients Hospitalized for Covid (Coronavirus Disease) 19

Overview

Clinical thoracic ultrasound plays an important role in the exploration, diagnosis and follow-up of thoracic pathologies. The COVID (Coronavirus Disease) epidemic is leading to a large influx of patients in the emergency department with respiratory disorders. The rapid diagnosis of respiratory disorders in infected patients is important for further management. Chest ultrasound has already demonstrated its value in the diagnosis of pneumonia in the emergency department with superiority over chest X-ray. However, there is little data on the thoracic ultrasound semiology of viral pneumonia in general and of COVID in particular.

Chest ultrasound has already shown its value in the diagnosis of pneumonia in the emergency department with superiority over chest X-ray. However, there is little data on the thoracic ultrasound semiology of viral pneumonia in general and of COVID in particular. Peng reported data from 20 patients and compared them to chest CT. The abnormalities are a thickening of the pleuropneumonia line, an interstitial syndrome with B lines, corresponding to frosted glass opacities, confluent B lines (snowstorm appearance) corresponding to interstitial infiltrate, sub-pleural alveolar opacities corresponding to sub-pleural condensations, more frank alveolar images corresponding to alveolar opacities. A multifocal aspect was associated with involvement of more than 2 lobes. However, the frequency of these abnormalities as well as the sensitivity of the echo are not detailed in this article. Another Italian article describes a clinical case of COVID-19 pneumonia with sub-pleural involvement and irregularity of the pleuro-pulmonary line. Clinical thoracic ultrasound has a major potential interest during the COVID epidemic: available at the patient's bedside, avoiding the need to move around, feasible for the physician during his visit, easy to clean especially if ultraportable devices are used, fast and not exposing the staff any more than the usual clinical examination. In order to determine whether this technique is useful in the management of infected patients or patients suspected of COVID-19 infection with respiratory signs, we propose a descriptive prospective study evaluating the ultrasound semiology of COVID-19 pneumonia and the interest of ultrasound in the evolutionary follow-up of these patients.