4.3 Review

The use of lung ultrasound in COVID-19

Journal

ERJ OPEN RESEARCH
Volume 9, Issue 1, Pages -

Publisher

EUROPEAN RESPIRATORY SOC JOURNALS LTD
DOI: 10.1183/23120541.00196-2022

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This review article discusses the role of lung ultrasound in COVID-19 patients for diagnosis and disease management. Lung ultrasound is a simple imaging procedure that helps identify COVID-19 patients early and informs treatment decisions. It can be performed in various clinical settings and has advantages such as non-ionising radiation and repeatability. However, the physical proximity between the patient and the operator is a limitation, and availability of trained staff is a major barrier. Training, advocacy, and awareness can help promote the use of lung ultrasound in COVID-19 management.
This review article addresses the role of lung ultrasound in patients with coronavirus disease 2019 (COVID-19) for diagnosis and disease management. As a simple imaging procedure, lung ultrasound contributes to the early identification of patients with clinical conditions suggestive of COVID-19, supports decisions about hospital admission and informs therapeutic strategy. It can be performed in various clinical settings (primary care facilities, emergency departments, hospital wards, intensive care units), but also in outpatient settings using portable devices. The article describes typical lung ultrasound findings for COVID-19 pneumonia (interstitial pattern, pleural abnormalities and consolidations), as one component of COVID-19 diagnostic workup that otherwise includes clinical and laboratory evaluation. Advantages and limitations of lung ultrasound use in COVID-19 are described, along with equipment requirements and training needs. To infer on the use of lung ultrasound in different regions, a literature search was performed using key words COVID-19, lung ultrasound and imaging. Lung ultrasound is a noninvasive, rapid and reproducible procedure; can be performed at the point of care; requires simple sterilisation; and involves non-ionising radiation, allowing repeated exams on the same patient, with special benefit in children and pregnant women. However, physical proximity between the patient and the ultrasound operator is a limitation in the current pandemic context, emphasising the need to implement specific infection prevention and control measures. Availability of qualified staff adequately trained to perform lung ultrasound remains a major barrier to lung ultrasound utilisation. Training, advocacy and awareness rising can help build up capacities of local providers to facilitate lung ultrasound use for COVID-19 management, in particular in low- and middle-income countries.

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