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Lung ultrasound findings in different infection stage
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PurposeFew data are currently available on persistent symptoms and late organ damage in patients who have suffered from COVID-19. This prospective study aimed to evaluate the results of a follow-up program for patients discharged from a nonintensive COVID-19 ward.Methods3–6 months after hospital discharge, 59 of 105 COVID-19 patients (31 males, age...
During the COVID-19 pandemic, use of telemedicine with the aim of reducing the rate of viral transmission increased. This proof-of-concept observational study was planned to test the feasibility of a home-based lung ultrasound (LUS) follow-up performed by patients with mild COVID-19 infection on themselves. We enrolled patients presenting to the em...
We propose using a pre-trained segmentation model to perform diagnostic classification in order to achieve better generalization and interpretability, terming the technique reverse-transfer learning. We present an architecture to convert segmentation models to classification models. We compare and contrast dense vs sparse segmentation labeling and...
Citations
... However, previous studies have indicated agreement between HR-CT and LUS. [31][32][33] LUS, on the other hand, proved to be superior to XR, which plays a completely marginal role in COVID-19 imaging. [33][34] Other tools (i.e. ...
... Volpicelli G et al., first published the ultrasound manifestation of COVID-19 in 20 patients, where 12-point LUS was performed by two experienced physicians (10). Xing C et al., reported pleural and B line involvement in all 36 patients with COVID-19 in their study, with 64% showing consolidation (11). They concluded that while these manifestations are not specific to COVID-19 and can be seen in other viral pneumonias, combining these results with history and clinical signs during a COVID-19 epidemic can be very helpful for diagnosing infected cases (10). ...
Objective: Chest computed tomography (CT) scans are the gold standard for identifying pulmonary involvement in pneumonia-like COVID-19 cases, albeit with certain drawbacks such as radiation exposure and high costs. This research aims to evaluate the diagnostic precision of a 12-point lung ultrasound (LUS) against a low-dose chest CT scan in identifying lung lesions associated with COVID-19. Methods: The study incorporated 100 consecutive patients, aged over 18 years, exhibiting suspected clinical symptoms of COVID-19 or inpatients requiring a low-dose chest CT scan for diagnosing asymptomatic COVID-19 lung lesions. All participants underwent a 12-point LUS, followed by a low-dose chest CT scan. Data analysis was conducted using STATA-16, with descriptive results presented as mean and standard deviation. Results: The study comprised 60 males and 40 females, with an average age of 43.0±16.9 years. The mean distribution of the patients' clinical features was calculated. The LUS demonstrated a sensitivity, specificity, and positive and negative predictive values of 97.5%, 86.4%, 83.3%, and 98%, respectively. Conclusion: The 12-point LUS exhibited high sensitivity and specificity in assessing pulmonary involvement in COVID-19 patients. Therefore, lung ultrasound results, combined with medical history and clinical examination, can serve as an effective triage tool for COVID-19 patients. The LUS, a swift, safe, and effective ionization tool, can potentially replace chest CT scans in scenarios such as CT scan unavailability, intensive care management, and patient follow-up.
... Another sonographic sign, found in 70 % of cases according to the literature [48], was a small subpleural consolidation [49]. More extensive subpleural thickening in the posterolateral regions was usually seen in ventilated patients and could be accompanied by air bronchograms [49][50][51][52]. Changes to the pleural line in COVID-19 were frequently visualised. ...
INTRODUCTION: Ultrasound examination (US) of the lungs has shown high efficiency in the diagnosis of COVID-19 pneumonia. The aim of the research was studying the correspondence of computed tomography (CT) US signs of the lungs and morphological data in patients with COVID-19 pneumonia. MATERIALS AND METHODS: The post hoc analysis included 388 patients who simultaneously underwent ultrasound and CT of the lungs. Lung ultrasound was performed according to the 16-zone “Russian Protocol”. Morphological data were obtained from the results of pathoanatomic examination of deceased patients. RESULTS: The comparison of signs detected by CT and ultrasound of the lungs was performed during a multidimensional correspondence analysis. The analysis was carried out using a three-dimensional solution that explained 64.9 % of inertia (p < 0.001). CT signs of “ground glass opacity” (100 %) corresponded to the B-line at ultrasound (100 %), CT of the consolidation sign (44.8 %) — ultrasound signs of consolidation (46.9 %), aerobronchogram of CT (34 %) — aerobronchogram of ultrasound (36.9 %), free liquid CT (11.1 %) — free liquid Ultrasound (13.9 %). CT signs of reticular changes (29.6 %) and “cobblestone pavement” (12.4 %) corresponded to various combinations of ultrasound signs of subpleural consolidation and B-lines. The B-lines were caused by the exudation of fluid and protein molecules into the intraalveolar space against the background of massive death of alveolocytes and formed by the development of intraalveolar edema and the formation of hyaline membranes. The ultrasonic sign of consolidation appeared in the airless zone of the lungs. Subpleural consolidation are caused by thickening and inflammatory infiltration of the pleura, diffuse alveolar damage, with intraalveolar edema, death and decay of alveolocytes, perivascular inflammatory cell reaction/ During treatment for more than 7 days, consolidation in the lung tissue developed due to the disorganization of the organ structure due to the progression of fibrosis. CONCLUSION: Multivariate correspondence analysis showed correlation of CT signs and US signs of the lungs. Morphological analysis showed polymorphism of histological data that caused the formation of ultrasound signs.
... Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, the use of lung ultrasound (LUS) has been globally and fastly spreading. Indeed, the main advantages of LUS (portability, cost-effectiveness, real-time imaging, and safety) compared to other imaging technologies such as, e.g., Computed Tomography (CT), allowed LUS to be widely adopted to evaluate the state of lungs in patients affected by COVID-19 [135,136,101,72,90,157,152,97,30]. Moreover, LUS can be nowadays used for patients' monitoring and for the triage of symptomatic patients [135]. ...
This thesis focuses on the issue of interpretability in machine learning, proposing algorithms to evolve decision trees (DTs) for reinforcement learning (RL) tasks. The dissertation is available at the following link: https://iris.unitn.it/handle/11572/375447.
... Sonographic features of COVID-19 pneumonia have been described in several studies [22][23][24][25]. In this sense, our study confirms previously published data regarding patient characteristics and sonographic abnormalities in this infection. ...
Background
Lung ultrasound (LUS) has proven to be useful in the evaluation of lung involvement in COVID-19. However, the effectiveness for predicting the risk of severe disease is still at debate. The aim of the study was to establish the prognostic accuracy of serial LUS examinations in the prediction of clinical deterioration in COVID-19 hospitalized patients.
Methods
Prospective single-center cohort study of patients hospitalized for COVID-19. The study protocol consisted of a LUS examination within 24 h from admission and a follow-up examination on day 3 of hospitalization. Lung involvement was evaluated by a fourteen-area LUS score. The primary endpoint was the ability of LUS to predict clinical deterioration defined as need for intensive respiratory support with high-flow oxygen or invasive mechanical ventilation.
Results
Two hundred patients were included and 35 (17.5%) of them reached the primary endpoint and were transferred to ICU. The LUS score at admission had been significantly higher in the ICU group than in the non-ICU group [22 (IQR 20–26) versus 12 (IQR 8–15)]. A LUS score at admission ≥17 showed to be the best cut-off point to discriminate patients with risk of deterioration (AUC 0.95). The absence of progression in LUS score on day 3, significantly increased the prediction accuracy by ruling out deterioration with a negative predictive value of 99.29%.
Conclusion
Serial LUS is a reliable tool in predicting the risk of respiratory deterioration in patients hospitalized due to COVID-19 pneumonia. LUS could be further implemented in the future for risk stratification of viral pneumonia.
... 22 In patients with COVID-19, ultrasound scans can identify pulmonary consolidation and a thickened pleural line by generating an image from high-frequency sound waves. 23 By combining a number of radiograph images taken at various angles to create a three-dimensional image, CT scans can create crosssectional images of various body parts 24 25 and its use in infectious disease is well established, particularly in the assessment of acute respiratory distress syndrome. 26 According to the literature, CT scans can help diagnose COVID-19 by identifying its associated pneumonia. ...
... 56 An international study 57 was conducted among 904 nurses across Japan, the Republic of Korea, the Republic of Turkey and the USA. It stated that CD-RISC-10 scores can be categorised as low (0-10), intermediate (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) and high (31)(32)(33)(34)(35)(36)(37)(38)(39)(40). Similarly, it was reported that an overall CD-RISC range=35. ...
Objectives This study aims to assess the level of resilience of medical workers in radiology departments in Riyadh, Kingdom of Saudi Arabia, during the COVID-19 outbreak and to explore associated factors.
Setting Medical staff, including nurses, technicians, radiology specialists and physicians, working in radiology departments at government hospitals in Riyadh, Saudi Arabia during the COVID-19 outbreak.
Design A cross-sectional study.
Participants The study was conducted among 375 medical workers in radiology departments in Riyadh, Kingdom of Saudi Arabia. The data collection took place from 15 February 2022 to 31 March 2022.
Results The total resilience score was 29.37±6.760 and the scores of each dimension showed that the higher mean score was observed in the domain of ‘flexibility’, while the lowest was observed in ‘maintaining attention under stress’. Pearson’s correlation analysis showed that there was a significant negative correlation between resilience and perceived stress (r=–0.498, p<0.001). Finally, based on multiple linear regression analysis, factors affecting resilience among participants are the availability of psychological hotline (available, B=2.604, p<0.050), knowledge of COVID-19 protective measures (part of understanding, B=−5.283, p<0.001), availability of adequate protective materials (partial shortage, B=−2.237, p<0.050), stress (B=−0.837, p<0.001) and education (postgraduate, B=−1.812, p<0.050).
Conclusions This study sheds light on the level of resilience and the factors that contribute to resilience in radiology medical staff. Moderate levels of resilience call for health administrators to focus on developing strategies that can effectively help cope with workplace adversities.
... Lung lesions of COVID-19 lead to intrapulmonary shunt [26] and to dysregulation of pulmonary perfusion [27]. Our findings prove that lung ultrasound is a simple tool to assess severity and to predict outcomes [17,28,29]. The high sensitivity and specificity of lung ultrasound [30][31][32] make it an important tool for the detection of severe forms. ...
Background:
Lung ultrasound is a non-invasive tool available at the bedside for the assessment of critically ill patients. The objective of this study was to evaluate the usefulness of lung ultrasound in assessing the severity of SARS-CoV-2 infection in critically-ill patients in a low-income setting.
Methods:
We conducted a 12-month observational study in a university hospital intensive care unit (ICU) in Mali, on patients admitted for COVID-19 as diagnosed by a positive polymerase chain reaction for SARS-CoV-2 and/or typical lung computed tomography scan findings.
Results:
The inclusion criteria was met by 156 patients with a median age of 59 years. Almost all patients (96%) had respiratory failure at admission and many needed respiratory support (121/156, 78%). The feasibility of lung ultrasound was very good, with 1802/1872 (96%) quadrants assessed. The reproducibility was good with an intra-class correlation coefficient of elementary patterns of 0.74 (95% CI 0.65, 0.82) and a coefficient of repeatability of lung ultrasound score < 3 for an overall score of 24. Confluent B lines were the most common lesions found in patients (155/156). The overall mean ultrasound score was 23 ± 5.4, and was significantly correlated with oxygen saturation (Pearson correlation coefficient of - 0.38, p < 0.001). More than half of the patients died (86/156, 55.1%). The factors associated with mortality, as shown by multivariable analysis, were: the patients' age; number of organ failures; therapeutic anticoagulation, and lung ultrasound score.
Conclusion:
Lung ultrasound was feasible and contributed to characterize lung injury in critically-ill COVID-19 patients in a low income setting. Lung ultrasound score was associated with oxygenation impairment and mortality.
... Another two studies reported that the LU features of COVID-19 pneumonia and ARDS can be used to assess disease severity in 20 25,26 patients with COVID-19 pneumonia. According to two narrative reviews, the LU score could be used to objectively grade COVID-19- 19,27 related lung injuries. ...
A study was conducted to assess the severity of COVID-19 pneumonia by ultrasonography compared to computed tomography. 50 patients, older than 18 years, referred to a major territory care centre in India between June and December 2021 with any two of the three criteria: fever, Spo2<94% on room air, and shortness of breath were studied. Patients proven to have COVID-19 pneumonia with either RT-PCR/RAT or Computed tomography scan were excluded from the study. Lung ultrasound was performed by two experienced physicians using a portable ultrasound device. A modied Lung Ultrasound Score for COVID-19 was compared with a computed tomography scan performed using a single inspiratory phase in a commercial multi-detector computed tomography scanner. Results: The correlation coefcient between the lung ultrasound score and the computed tomography severity score (r) was 0.79 (strong correlation) with a p value <0.00001 (signicant as p value <0.05). In patients with moderate to severe disease, the correlation was stronger. Conclusions: Our study showed that there is a good correlation between the lung ultrasound score and Computed tomography severity score. Lung ultrasound may help as an alternative method for diagnosing and isolating COVID-19 pneumonia patients during the peaks of the pandemic. Lung ultrasound score exhibited similar accuracy compared with chest computed tomography in the detection of lung abnormalities in COVID-19 patients.
... Xing Ch y otros (41) caracterizaron los hallazgos ecográficos de nSARS-CoV-2 y estudiaron la relación entre los hallazgos ecográficos, gravedad clínica y el curso temporal de la enfermedad. Se realizó EP para detectar líneas B, consolidación pulmonar y anomalías de la línea pleural en cinco áreas de cada pulmón. ...
Introducción:
La ecografía pulmonar es una técnica que proporciona información de mucha utilidad en el abordaje diagnóstico de pacientes con infección por el virus SARS-CoV-2. Las infiltraciones detectadas en la ecografía pulmonar pueden sugerir edema pulmonar, infarto o neumonía lobar, la cual ofrece alta disponibilidad y la posibilidad de evaluar al paciente in situ. Se realizó una búsqueda en los motores: Google Scholar, National Library of Medicine PudMed, SciELO regional desde 2019. En la estrategia de la búsqueda se utilizaron los términos: ecografía pulmonar / técnica, métodos diagnósticos, hallazgos patológicos. En la búsqueda bibliográfica realizada se encontraron 24 artículos relacionados con los hallazgos patológicos en la ecografía pulmonar y el valor diagnóstico de lesiones pulmonares.
Objetivo:
Describir los hallazgos fundamentales de la ecografía pulmonar en el diagnóstico de lesiones graves producidas por el virus SARS-CoV-2.
Desarrollo:
Los estudios reportaron precisión similar de la ecografía pulmonar en comparación con la tomografía de tórax en la detección de anomalías pulmonares, su relación con el estado de gravedad y en la estratificación del riesgo en pacientes graves con SARS-CoV-2.
Conclusiones:
La ecografía permite una evaluación constante y no invasiva de lesiones pulmonares causadas por el virus SARS-CoV-2, permite una identificación correcta de la gravedad y su evolución. Es un método diagnóstico que disminuye el riesgo de exposición a radiaciones ionizantes, incrementando la seguridad al paciente grave.
... Xing Ch y otros (41) caracterizaron los hallazgos ecográficos de nSARS-CoV-2 y estudiaron la relación entre los hallazgos ecográficos, gravedad clínica y el curso temporal de la enfermedad. Se realizó EP para detectar líneas B, consolidación pulmonar y anomalías de la línea pleural en cinco áreas de cada pulmón. ...
Introducción: La ecografía pulmonar es una técnica que proporciona información de mucha utilidad en el abordaje diagnóstico de pacientes con infección por el virus SARS-CoV-2. Las infiltraciones detectadas en la ecografía pulmonar pueden sugerir edema pulmonar, infarto o neumonía lobar, la cual ofrece alta disponibilidad y la posibilidad de evaluar al paciente in situ. Se realizó una búsqueda en los motores: Google Scholar, National Library of Medicine PudMed, SciELO regional desde 2019. En la estrategia de la búsqueda se utilizaron los términos: ecografía pulmonar / técnica, métodos diagnósticos, hallazgos patológicos. En la búsqueda bibliográfica realizada se encontraron 24 artículos relacionados con los hallazgos patológicos en la ecografía pulmonar y el valor diagnóstico de lesiones pulmonares. Objetivo: Describir los hallazgos fundamentales de la ecografía pulmonar en el diagnóstico de lesiones graves producidas por el virus SARS-CoV-2. Desarrollo: Los estudios reportaron precisión similar de la ecografía pulmonar en comparación con la tomografía de tórax en la detección de anomalías pulmonares, su relación con el estado de gravedad y en la estratificación del riesgo en pacientes graves con SARS-CoV-2. Conclusiones: La ecografía permite una evaluación constante y no invasiva de lesiones pulmonares causadas por el virus SARS-CoV-2, permite una identificación correcta de la gravedad y su evolución. Es un método diagnóstico que disminuye el riesgo de exposición a radiaciones ionizantes, incrementando la seguridad al paciente grave. Palabras clave: infecciones por coronavirus; ultrasonografía; neumonía. ABSTRACT Introduction: Lung ultrasound is a technique that provides very useful information in the diagnostic approach of patients with SARS-CoV-2 virus infection. The infiltrations detected in the pulmonary ultrasound may suggest pulmonary edema, infarction or lobar pneumonia, which offers high availability and the possibility of evaluating the patient in situ. A search was carried out in the engines: Google Scholar, National Library of Medicine PudMed, SciELO regional since 2019. The search strategy used the terms: pulmonary ultrasound / technique, diagnostic methods, pathological findings. In the bibliographic search carried out, 24 articles were found related to pathological findings in lung ultrasound and the diagnostic value of lung lesions. Objective: To describe the fundamental findings of lung ultrasound in the diagnosis of serious lesions caused by the SARS-CoV-2 virus. Development: Studies reported similar precision of lung ultrasound compared to chest tomography in detecting lung abnormalities, their relationship to severity status, and risk stratification in critically ill patients with SARS-CoV-2.
