| Understanding of Patients with Severe COVID-19 Using Lung Ultrasound |
Seo-Hee Yang, M.D.1,2 
, Eun Ju Park, M.S.N., R.N.1, Jung-Hyun Kim, M.D., Ph.D.3, Jin Woo Song, M.D., Ph.D.4, Young-Jae Cho, M.D., M.P.H., Ph.D.1
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1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
2Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Seoul Veterans Hospital, Seoul, Republic of Korea
3Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
4Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea |
Correspondence:
Young-Jae Cho, Tel: 82-31-787-7058, Fax: 82-31-787-4050,
Email: lungdrcho@snu.ac.kr
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Received: 12 March 2024 • Revised: 17 June 2024 • Accepted: 2 January 2025 |
| Abstract |
Background
Lung ultrasound (LUS) has proven valuable in the initial assessment of coronavirus disease 2019 (COVID-19), but its role in detecting pulmonary fibrosis following intensive care remains unclear. This study aims to assess the presence of pulmonary sequelae and fibrosis-like changes using LUS in survivors of severe COVID-19 pneumonia one month after discharge.
Methods
We prospectively enrolled patients with severe COVID-19 who required mechanical ventilation in the intensive care unit (ICU) and conducted LUS assessments from admission to the outpatient visit after discharge. We tracked changes in key LUS findings and applied our proprietary LUS scoring system. To evaluate LUS accuracy, we correlated measured LUS values with computed tomography scores.
Results
We evaluated B-line presence, pleural thickness, and consolidation in 14 eligible patients. The LUS scores exhibited minimal changes, with values of 19.1, 19.2, and 17.5 at admission, discharge, and the outpatient visit, respectively. Notably, the number of B-lines decreased significantly, from 1.92 at admission to 0.56 at the outpatient visit (p<0.05), while pleural thickness increased significantly, from 2.05 at admission to 2.48 at the outpatient visit (p≤0.05).
Conclusion
This study demonstrates that LUS can track changes in lung abnormalities in severe COVID-19 patients from ICU admission through to outpatient follow-up. While pleural thickening and B-line patterns showed significant changes, no correlation was found between LUS and high-resolution computed tomography fibrosis scores. These findings suggest that LUS may serve as a supplementary tool for assessing pulmonary recovery in severe COVID-19 cases. |
| Key Words:
COVID-19, Ultrasound, Acute Respiratory Disease Syndrome, Pulmonary Fibrosis |
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