Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
Respir Med. 2022 Jun;197:106826. doi: 10.1016/j.rmed.2022.106826. Epub 2022 Apr 2.
Lung ultrasound (LUS) is a useful tool for diagnosis and monitoring in patients with active COVID-19-infection. However, less is known about the changes in LUS findings after a hospitalization for COVID-19.
In a prospective, longitudinal study in patients with COVID-19 enrolled from non-ICU hospital units, adult patients underwent 8-zone LUS and blood sampling both during the hospitalization and 2-3 months after discharge. LUS images were analyzed blinded to clinical variables and outcomes.
A total of 71 patients with interpretable LUS at baseline and follow up (mean age 64 years, 61% male, 24% with acute respiratory distress syndrome (ARDS)) were included. The follow-up LUS was performed a median of 72 days after the initial LUS performed during hospitalization. At baseline, 87% had pathologic LUS findings in ≥1 zone (e.g. ≥3 B-lines, confluent B-lines or subpleural or lobar consolidation), whereas 30% had pathologic findings at follow-up (p < 0.001). The total number of B-lines and LUS score decreased significantly from hospitalization to follow-up (median 17 vs. 4, p < 0.001 and 4 vs. 0, p < 0.001, respectively). On the follow-up LUS, 28% of all patients had ≥3 B-lines in ≥1 zone, whereas in those with ARDS during the baseline hospitalization (n = 17), 47% had ≥3 B-lines in ≥1 zone.
LUS findings improved significantly from hospitalization to follow-up 2-3 months after discharge in COVID-19 survivors. However, persistent B-lines were frequent at follow-up, especially among those who initially had ARDS. LUS seems to be a promising method to monitor COVID-19 lung changes over time.
NCT04377035.
肺部超声(LUS)是诊断和监测活动性 COVID-19 感染患者的有用工具。然而,对于 COVID-19 住院治疗后 LUS 检查结果的变化知之甚少。
在一项前瞻性、纵向研究中,招募了来自非 ICU 医院病房的 COVID-19 成年患者,在住院期间和出院后 2-3 个月进行 8 区 LUS 和血液采样。LUS 图像的分析是盲法进行的,不考虑临床变量和结果。
共纳入 71 例基线和随访时可解释的 LUS 患者(平均年龄 64 岁,61%为男性,24%为急性呼吸窘迫综合征(ARDS))。随访 LUS 是在住院期间首次 LUS 检查后中位数 72 天进行的。基线时,87%的患者在至少 1 个区域存在病理性 LUS 表现(如≥3 条 B 线、融合的 B 线或亚胸膜或肺叶实变),而 30%在随访时存在病理性表现(p<0.001)。从住院到随访,B 线总数和 LUS 评分均显著下降(中位数分别为 17 与 4,p<0.001 和 4 与 0,p<0.001)。在随访 LUS 上,所有患者中有 28%的至少 1 个区域有≥3 条 B 线,而在基线住院期间有 ARDS 的患者(n=17)中,有 47%的至少 1 个区域有≥3 条 B 线。
COVID-19 幸存者从住院到出院后 2-3 个月的随访,LUS 检查结果明显改善。然而,在随访时,B 线持续存在的情况很常见,尤其是在最初患有 ARDS 的患者中。LUS 似乎是一种有前途的方法,可以随时间监测 COVID-19 肺部变化。
NCT04377035。