Lung ultrasound findings following COVID-19 hospitalization: A prospective longitudinal cohort study. (June 2022)

• Record Type: Journal Article
• Authors: Espersen, Caroline; Platz, Elke; Alhakak, Alia Saed; Sengeløv, Morten; Simonsen, Jakob Øystein; Johansen, Niklas Dyrby; Davidovski, Filip Søskov; Christensen, Jacob; Bundgaard, Henning; Hassager, Christian; Jabbari, Reza; Carlsen, Jørn; Kirk, Ole; Lindholm, Matias Greve; Kristiansen, Ole Peter; Nielsen, Olav Wendelboe; Jeschke, Klaus Nielsen; Ulrik, Charlotte Suppli; Sivapalan, Pradeesh; Iversen, Kasper; Stæhr Jensen, Jens Ulrik; Schou, Morten; Skaarup, Søren Helbo; Højbjerg Lassen, Mats Christian; Skaarup, Kristoffer Grundtvig; Biering-Sørensen, Tor
• Is Part Of: Respiratory medicine. Volume 197(2022)
• Publication Date: 2022-06
• Subjects: Lung ultrasound -- COVID-19 -- Longitudinal follow-up; LUS lung ultrasound -- CT computed tomography -- AHF acute heart failure -- ARDS acute respiratory distress syndrome -- IQR interquartile range; 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.2022.106826
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Background: Lung ultrasound (LUS) is a useful tool for diagnosis and monitoring in patients with active COVID-19-infection. However, less is known about the changes in LUS findings after a hospitalization for COVID-19. Methods: In a prospective, longitudinal study in patients with COVID-19 enrolled from non-ICU hospital units, adult patients underwent 8-zone LUS and blood sampling both during the hospitalization and 2–3 months after discharge. LUS images were analyzed blinded to clinical variables and outcomes. Results: A total of 71 patients with interpretable LUS at baseline and follow up (mean age 64 years, 61% male, 24% with acute respiratory distress syndrome (ARDS)) were included. The follow-up LUS was performed a median of 72 days after the initial LUS performed during hospitalization. At baseline, 87% had pathologic LUS findings in ≥1 zone (e.g. ≥3 B-lines, confluent B-lines or subpleural or lobar consolidation), whereas 30% had pathologic findings at follow-up (p < 0.001). The total number of B-lines and LUS score decreased significantly from hospitalization to follow-up (median 17 vs. 4, p < 0.001 and 4 vs. 0, p < 0.001, respectively). On the follow-up LUS, 28% of all patients had ≥3 B-lines in ≥1 zone, whereas in those with ARDS during the baseline hospitalization (n = 17), 47% had ≥3 B-lines in ≥1 zone. Conclusion: LUS findings improved significantly from hospitalization to follow-up 2–3 months after discharge in COVID-19 survivors. However, persistent B-lines were frequent at follow-up, especially among those who initially had ARDS. LUS seems to be a promising method to monitor COVID-19 lung changes over time. Clinicaltrials.gov ID: NCT04377035. Highlights: Among 71 COVID-19 survivors, pathologic findings on LUS improved significantly from hospitalization to 2–3 months after discharge. Persistent B-lines were frequent at follow-up, especially among those who developed ARDS during the hospitalization. LUS seems to be a promising method to monitor COVID-19 lung changes over time.