Proposal for International Standardization of the Use of Lung Ultrasound for Patients With COVID-19: A Simple, Quantitative, Reproducible Method

Gino Soldati, Andrea Smargiassi, Riccardo Inchingolo, Danilo Buonsenso, Tiziano Perrone, Domenica Federica Briganti, Stefano Perlini, Elena Torri, Alberto Mariani, Elisa Eleonora Mossolani, Francesco Tursi, Federico Mento, Libertario Demi, Gino Soldati, Andrea Smargiassi, Riccardo Inchingolo, Danilo Buonsenso, Tiziano Perrone, Domenica Federica Briganti, Stefano Perlini, Elena Torri, Alberto Mariani, Elisa Eleonora Mossolani, Francesco Tursi, Federico Mento, Libertario Demi

Abstract

Growing evidence is showing the usefulness of lung ultrasound in patients with the 2019 new coronavirus disease (COVID-19). Severe acute respiratory syndrome coronavirus 2 has now spread in almost every country in the world. In this study, we share our experience and propose a standardized approach to optimize the use of lung ultrasound in patients with COVID-19. We focus on equipment, procedure, classification, and data sharing.

Keywords: COVID-19; lung ultrasound; point-of-care ultrasound; scoring system.

© 2020 by the American Institute of Ultrasound in Medicine.

Figures

Figure 1
Figure 1
Schematic representation of the acquisition landmarks on chest anatomic lines.
Figure 2
Figure 2
Lung US images obtained with linear (A and B) and convex (C and D) transducers. The pleura lines (indicated by red arrows) is continuous. Below, horizontal artifacts (indicated by blue arrows) may be visible. This pattern is classified as score 0.
Figure 3
Figure 3
Lung US images obtained with linear (A) and convex (B) transducers. The pleural line is not continuous. Below the point of discontinuity (indicated by red arrows), vertical areas of white are visible (indicated by blue arrows). This pattern is classified as score 1.
Figure 4
Figure 4
Lung US images obtained with linear (A and B) and convex (C and D) transducers. The pleural line is severely broken. Below the point of discontinuity (indicated by orange arrows), small consolidated areas (darker areas indicated by red arrows) appear with associated areas of white (indicated by blue arrows) in correspondence with the consolidations. This pattern is classified as score 2.
Figure 5
Figure 5
Lung US images obtained with linear (A and B) and convex (C) transducers. The pleural line is severely broken. Below the point of discontinuity, large consolidated areas (darker areas indicated by red arrows) appear with a generalized white lung pattern (indicated by orange arrows). This pattern is classified as score 2. In the box at the right bottom (D), a LUS image is shown where the edge between a score of 0 (green box) and a score of 3 (purple box) pattern is clearly visible.

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Source: PubMed

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