A new approach in the diagnosis of lung lesions in patients with COVID-19: lung ultrasound protocol versus CT scan

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Abstract

Aim. To develop a protocol for ultrasound diagnostics of COVID-19 pneumonia and to assess the diagnostic capabilities of the method in comparison with computer tomography (CT).

Materials and methods. The study included 59 patients with a new coronavirus infection. In order to identify changes in the lung tissue characteristic of a new coronavirus infection, we used a special protocol for ultrasound of the lungs, which was developed by us in such a way that the data obtained were compared by segment with the results of CT of the lungs.

Results. When comparing the results of lung ultrasound with the data of CT diagnostics, according to the new protocol, the percentage of lung tissue damage during ultrasound of the lungs averaged 70.8% in the group [62.5; 87.5], and according to the results of CT – 70.0% [60.0; 72.5] (p=0.427). Thus, the ultrasound of the lung lesions was almost completely consistent with the changes revealed by CT. In order to assess the diagnostic value of lung ultrasound in identifying severe lung tissue lesions corresponding to CT 3–4, ROC analysis was performed, which showed the high diagnostic value of lung ultrasound in identifying severe lung tissue lesions.

Conclusion. A new protocol was developed for assessing the severity of lung tissue damage according to ultrasound data, which showed a high diagnostic value in detecting COVID-19 pneumonia in comparison with CT. The results obtained give reason to recommend this protocol of ultrasound of the lungs as a highly sensitive method in diagnosing the severity of COVID-19 pneumonia. Its application is very important for dynamic examination of patients, especially in conditions of low availability of CT.

About the authors

Marina A. Saidova

Chazov National Medical Research Center of Cardiology

Email: ani_avalian@mail.ru
ORCID iD: 0000-0002-3233-1862

д-р мед. наук, проф., рук. отд. ультразвуковых методов исследования

Russian Federation, Moscow

Ani A. Avalyan

Chazov National Medical Research Center of Cardiology

Author for correspondence.
Email: ani_avalian@mail.ru
ORCID iD: 0000-0003-0442-4495

мл. науч. сотр. отд. ультразвуковых методов исследования

Russian Federation, Moscow

Mareta A. Galaeva

Chazov National Medical Research Center of Cardiology

Email: ani_avalian@mail.ru
ORCID iD: 0000-0002-8097-9030

врач отд. ультразвуковых методов исследования

Russian Federation, Moscow

Mikhail B. Belkind

Chazov National Medical Research Center of Cardiology

Email: ani_avalian@mail.ru
ORCID iD: 0000-0003-4377-5722

науч. сотр. отд. томографии

Russian Federation, Moscow

References

  1. World Health Association. WHO coronavirus disease dashboard Update of 2020/8/17. Available at: https://covid19.who.int/. Accessed: 08.12.2021.
  2. Ottaviani S, Franc M, Ebstein E, et al. Lung ultrasonography in patients with COVID-19: comparison with CT. Clin Radiol. 2020;75:877.e1e877.e6. doi: 10.1016/j.crad.2020.07.024
  3. Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19). Временные методические рекомендации. Министерство здравоохранения Российской Федерации. Версия 8 (03.09.2020). М., 2020 [Profilaktika, diagnostika i lechenie novoi koronavirusnoi infektsii (COVID-19). Vremennye metodicheskie rekomendatsii. Ministerstvo zdravookhraneniia Rossiiskoi Federatsii. Versiia 8 (03.09.2020). Moscow, 2020 (in Russian)].
  4. Chung M, Bernheim A, Mei X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology. 2020;295(1):202e7. doi: 10.1148/radiol.2020200230
  5. Ai T, Yang Z, Hou H, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. 2020:200642. doi: 10.1148/radiol.2020200642
  6. Bouhemad B, Brisson H, Le Guen M, et al. Bedside Ultrasound Assessment of Positive End-Expiratory Pressure-induced Lung Recruitment. Am J Respir Crit Care Med. 2011;183:341-7. doi: 10.1164/rccm.201003-0369OC
  7. Mojoli F, Bouhemad B, Mongodi S, Lichtenstein D. Lung Ultrasound for Critically Ill Patients. Am J Respir Crit Care Med. 2019;199(6):701-14. doi: 10.1164/rccm.201802-0236CI
  8. Soldati G, Smargiassi A, Inchingolo R, et al Proposal for International Standardization of the Use of LungUltrasound for Patients With COVID-19. J Ultrasound Med. 2020; 9999:1-7. doi: 10.1002/jum.15285
  9. Сафарова А.Ф., Кобалава Ж.Д., Рачина С.А., и др. Роль и возможности ультразвукового исследования легких у пациентов с коронавирусной пневмонией. Клиническая фармакология и терапия. 2020;29(2):52-6 [Safarova AF, Kobalava ZhD, Rachina SA, et al. The use of lung ultrasound in patients with COVID-19. Klinicheskaia farmakologiia i terapiia. 2020;29(2):52-6 (in Russian)]. doi: 10.32756/0869-5490-2020-2-51-55
  10. Chung M, Bernheim A, Mei X, et al. CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology. 2020;295:202-7. doi: 10.1148/radiol.2020200230
  11. Oliveira BA, Oliveira LC, Sabino EC, Okay TS. SARS-CoV-2 and the COVID-19 disease: a mini review on diagnostic methods. Rev Inst Med Trop São Paulo. 2020;62:e44:1-8. doi: 10.1590/S1678-9946202062044
  12. Soccorsa S, Boccatonda A, Montanari M, et al. Thoracic ultrasound and SARS-COVID-19: a pictorial essay. J Ultrasound. 2020;23:217-21. doi: 10.1007/s40477-020-00458-7
  13. Smith MJ, Hayward SA, Innes SM, Miller ASC. Point-of-care lung ultrasound in patients with COVID-19 – a narrative review. Anaesthesia. 2020;75(8):1096-104. doi: 10.1111/anae.15082
  14. Kobalava ZD, Ayten FS, Montoya CFE, et aI. A single-center comparative study of lung ultrasound versus chest computed tomography during the COVID-19 era. Multidiscip Respir Med. 2021;16(1):766. doi: 10.4081/mrm.2021.766

Supplementary files

Supplementary Files
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2. Fig. 1. An example of a lung ultrasound protocol with an assessment of the severity of the lesion.

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3. Fig. 2. Lung ultrasound in a patient with COVID-19. The figure shows subpleural consolidations.

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4. Fig. 3. Lung ultrasound in a patient with COVID-19. The figure shows changes of the "white lung" type.

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5. Fig. 4. Diagnostic value of lung ultrasound in detecting severe damage to the lung tissue. Sensitivity was 94.7% and specificity was 85.7% (area under the curve, 0.853; 95% confidence interval, 0.660–0.959).

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6. Fig. 5. Comparison of lung ultrasound with CT data according to the developed protocol in a patient with COVID-19 upon admission to the hospital.

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7. Fig. 6. Comparison of lung ultrasound with CT data according to the developed protocol in a patient with COVID-19 in dynamics.

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