Lung ultrasonography for long-term follow-up of COVID-19 survivors compared to chest CT scan. (May 2021)

• Record Type: Journal Article
• Authors: Giovannetti, Guido; De Michele, Lucrezia; De Ceglie, Michele; Pierucci, Paola; Mirabile, Alessandra; Vita, Marco; Palmieri, Vincenzo Ostilio; Carpagnano, Giovanna Elisiana; Scardapane, Arnaldo; D'Agostino, Carlo
• Is Part Of: Respiratory medicine. Volume 181(2021)
• Publication Date: 2021-05
• Subjects: COVID-19 follow-up -- Lung ultrasonography -- Chest computed tomography -- Interstitial lung disease -- ILD -- Hypoxemic acute respiratory failure; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2021.106384
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Background: While lung ultrasonography (LUS) has utility for the evaluation of the acute phase of COVID-19 related lung disease, its role in long-term follow-up of this condition has not been well described. The objective of this study is to compare LUS and chest computed tomography (CT) results in COVID-19 survivors with the intent of defining the utility of LUS for long-term follow-up of COVID-19 respiratory disease. Methods: Prospective observational study that enrolled consecutive survivors of COVID-19 with acute hypoxemic respiratory failure (HARF) admitted to the Respiratory Intensive Care Unit. Three months following hospital discharge, patients underwent LUS, chest CT, body plethysmography and laboratory testing, the comparison of which forms the basis of this report. Results: 38 patients were enrolled, with a total of 190 lobes analysed: men 27/38 (71.1%), mean age 60.6 y (SD 10.4). LUS findings and pulmonary function tests outcomes were compared between patients with and without ILD, showing a statistically significant difference in terms of LUS score (p: 0.0002), FEV1 (p: 0.0039) and FVC (p: 0.012). ROC curve both in lobe by lobe and in patient's overall analysis revealed an outstanding ILD discrimination ability of LUS (AUC: 0.94 and 0.95 respectively) with a substantial Cohen's coefficient (K: 0.74 and 0.69). Conclusions: LUS has an outstanding discrimination ability compared to CT in identifying an ILD of at least mild grade in the post COVID-19 follow-up. LUS should be considered as the first-line tool in follow-up programs, while chest CT could be performed based on LUS findings. Highlights: LUS strongly correlates with CT in post COVID-19 ILD assessment. LUS should be added to follow-up post COVID-19 diagnostic evaluation. In post COVID-19 ILD evaluation, LUS should be first-line exam. Chest CT post COVID-19 infection could be performed based on LUS outcomes.