The following is a summary of the “Feasibility of a New Lung Ultrasound Protocol to Determine the Extent of Lung Injury in COVID-19 Pneumonia,” published in the January 2023 issue of Chest by Volpicelli et al.

In COVID-19-related acute respiratory distress syndrome (CoARDS), lung ultrasound (LUS) scanning helps diagnose and evaluate the severity of pulmonary lesions. Loss of oxygen saturation scores, which have been used for some time, is proposed to quantify this phenomenon in CoARDS. However, this score was validated in ICU patients with ARDS before COVID-19 and did not consider the differences with CoARDS. Typical signs of COVID-19 pneumonia on the lung surface can be graded as a percentage as part of an alternative LUS method (LUSext).

Patients with confirmed cases of COVID-19 who presented to the ED with symptoms of pneumonia on bedside LUS and CT scans were included in this observational study. The magnitude of LUSext was graphically represented. In addition, a retrospective analysis was performed on all CT scan studies using dedicated software to determine CTvol. Each score was correlated with the Pao₂/Fio₂ ratio, and the correlation between LUSext and CTvol was determined. A total of 179 patients’ records were analyzed. It was determined that LUSext was completely feasible.

The average duration of a LUS scan was 5 minutes and 1.5 seconds. Positive correlations were found between LUSext and CTvol (R = 0.67; P<.0001). On the contrary, the Pao₂/Fio₂ ratio was negatively correlated with both LUSext and CTvol (R = -0.66 and -0.54; P<.0001, respectively). Compared to a CT scan, LUSext reliably assesses the severity of lesions. Both LUSext and CTvol are correlated and negatively correlate with respiratory failure severity. The clinical and prognostic impact of LUSext, a simple and convenient bedside measure of pneumonia severity in CoARDS, needs further investigation.

Source: https://www.sciencedirect.com/science/article/pii/S0012369222013447