Lung Ultrasound for COVID-19 Patchy Pneumonia: Extended or Limited Evaluations?

Smargiassi, Andrea; Soldati, Gino; Torri, Elena; Mento, Federico; Milardi, Domenico; Giacomo, Paola Del; De Matteis, Giuseppe; Burzo, Maria Livia; Larici, Anna Rita; Pompili, Maurizio; Demi, Libertario; Inchingolo, Riccardo

OBJECTIVES The 2019 novel coronavirus (severe acute respiratory syndrome coronavirus 2) is causing cases of severe pneumonia. Lung ultrasound (LUS) could be a useful tool for physicians detecting a bilateral heterogeneous patchy distribution of pathologic findings in a symptomatic suggestive context. The aim of this study was to focus on the implications of limiting LUS examinations to specific regions of the chest. METHODS Patients were evaluated with a standard sequence of LUS scans in 14 anatomic areas. A scoring system of LUS findings was reported, ranging from 0 to 3 (worst score, 3). The scores reported on anterior, lateral, and posterior landmarks were analyzed separately and compared with each other and with the global findings. RESULTS Thirty-eight patients were enrolled. A higher prevalence of score 0 was observed in the anterior region (44.08%). On the contrary, 21.05% of posterior regions and 13.62% of lateral regions were evaluated as score 3, whereas only 5.92% of anterior regions were classified as score 3. Findings from chest computed tomography performed in 16 patients with coronavirus disease 2019 correlated with and matched the distribution of findings from LUS. CONCLUSIONS To assess the quantity and severity of lung disease, a comprehensive LUS examination is recommended. Omitting areas of the chest misses involved lung.