MedStar Investigates Point of Care Lung Ultrasound for COVID-19 Patients

Recently published research evaluated lung ultrasound findings in patients admitted to the internal medicine ward with COVID-19. “Point-of-Care Lung Ultrasound Findings in Patients with Novel Coronavirus Disease (COVID-19) Pneumonia” was published in The American Journal of Tropical Medicine and Hygiene. The study sought to diagnose and monitor patients who received point-of-care ultrasound and assess the findings.

The research was led by Kosuke Yasukawa from the Department of Medicine at MedStar Washington Hospital Center, in collaboration with Taro Minami from Care New England Medical Group and The Warren Alpert Medical School of Brown University.

Patients with COVID-19 typically present with bilateral multilobar ground-glass characteristics. Chest CT has been used in the diagnosis and management of patients with COVID-19. However, CT is not always readily available and the disinfection of CT machine after the use of a patient with COVID-19 may result in a delay of care for other patients requiring CT examination. While the utility of point-of-care ultrasound has been suggested, detailed descriptions of lung ultrasound findings are not available.

The research team retrospectively evaluated lung ultrasound images of 10 patients who received point-of-care ultrasound and were diagnosed with COVID-19. The images were stored and reviewed to determine demographics, comorbidities, laboratory, and radiographic findings. The findings showed that characteristic glass rockets with or without the Birolleau variant (white lung) were present in all 10 patients. One patient required transfer to intermediate care unit, and another patient required transfer to intensive care unit. Four of the patients required administration of oxygen via a non-rebreather mask. Abnormal lung ultrasound findings were detected in all of the patients. Two patients had septal rockets and small subpleural consolidations were detected in five patients. Although glass rockets and the Birolleau variant can be seen in patients with cardiogenic pulmonary edema, none of the patients were diagnosed with decompensated congestive heart failure.

The results found confluent B lines and thick, irregular pleural lines present in all patients evaluated. The glass rockets, confluent B lines, thick irregular pleural lines, and subpleural consolidations are likely not specific to COVID-19. However, these findings can be an aid for diagnosis during the COVID-19 pandemic when pretest probability is high.

The American Journal of Tropical Medicine and Hygiene, 2020. DOI: 10.4269/ajtmh.20-0280