Lung Ultrasound and Sonographic Subpleural Consolidation in COVID-19 Pneumonia Correlate with Disease Severity

Bitar, Zouheir Ibrahim; Shamsah, Mohammed; Maadarani, OssamaSajeh; Bamasood, Omar Mohammed; Bitar, Ali Zouheir; Alfoudri, Huda

INTRODUCTION: One of the ultrasonic features of COVID-19 pneumonia is the presence of subpleural consolidation (SPC), and the number of SPCs varies among patients with COVID-19 pneumonia. AIM: To examine the relationship between disease severity and the number of SPCs on admission. Methodology. This observational, prospective, single‐center study included patients with suspected COVID-19 infection who had been transferred to the ICU. A specialized intensivist in critical care ultrasound performed lung ultrasound (LUS) and echocardiography within 12 hours of a patient's admission to the ICU. The aeration score was calculated, and the total number of SPCs was quantified in 12 zones of the LUS. RESULTS: Of 109 patients with suspected COVID-19 pneumonia, 77 (71%) were confirmed. The median patient age was 53 (82–36) years, and 81 of the patients (73.7%) were men. The aeration score and the counts of subpleural consolidation in each zone were significantly higher in patients with COVID-19 pneumonia (P=0.018 and P < 0.0001, respectively). There was an inverse relationship between PO(2)/FiO(2), the aeration score, and the number of subpleural consolidations. The higher the number of SPCs, the worse the PO(2)/FiO(2) will be. CONCLUSIONS: Sonographic SPC counts correlate well with the severity of COVID-19 pneumonia and PO(2)/FiO(2). The number of SPCs should be considered when using LUS to assess disease severity.