# COVID-19, Lung Ultrasound

- Link: https://sifsof.com/clinical-apps/covid-19-lung-ultrasound/
- Published: 2020-03-19T16:13:18+00:00
- Author: Developer

Now declared pandemic, the outbreak of the new coronavirus (COVID-19) that was first
detected in China late last year has infected nearly 200.000 people in more than
150 countries.

 The most common symptoms are fever and cough with a median incubation period of
4 days. The characteristic feature (and also the initial cluster observation that
allowed the suspicion of a novel disease) is a development of **pneumonia** that,
on chest computed tomography (CT), is seen as ground-glass opacity as main finding.
Another characteristic feature is the frequent observation of lymphocytopenia (in
83.2% of the patients on admission).

 As lung abnormalities may develop before clinical manifestations and nucleic acid
detection, experts have recommended early chest computerized tomography (CT) for
screening suspected patients.

The high contagiousness of SARS-CoV-2 and the risk of transporting unstable patients
with hypoxemia and hemodynamic failure make chest CT a limited option for the patient
with suspected or established COVID-19.

Lung ultrasonography gives the results that are similar to chest CT and superior
to standard chest radiography for evaluation of pneumonia and/or adult respiratory
distress syndrome (ARDS) with the added advantage of ease of use at point of care,
repeatability, absence of radiation exposure, and low cost

According to new literature and use case of ultrasound in COVID-19 cases – [ D. Buonsenso, A. Piano, F. Raffaelli, N. Bonadia, K. de Gaetano Donati, F. Franceschi _Point-of-Care Lung Ultrasound findings in novel coronavirus disease-19 pnemoniae: a case report and potential applications during COVID-19 outbreak_ ](https://www.europeanreview.org/wp/wp-content/uploads/2776-2780.pdf)
and the findings of [Dr Qian-Yi Peng & Li-Na Zhang and Dr Xiao-Ting Wang](https://link.springer.com/article/10.1007/s00134-020-05996-6)
in the regard. Lung ultrasound allowed the identification of nCoV-19 infection at
bed-side.

 Lung ultrasound can have several other advantages, such as reduced health worker
exposition to infected patients, repeatability during follow-up, low-costs and easier
application in low-resource settings.

###  **Which ultrasound scanner is used for COVID-19 Lung Ultrasound?**

 Lung ultrasound is performed with a portable convex probe (3.5 mHz) [SIFULTRAS-5.42](https://sifsof.com/product/double-head-wifi-color-ultrasound-scanner-sifultras-5-42-fda/),
wireless-connected with a tablet. Such a device minimizes the risk of contamination
of devices and subsequent nosocomial spread.

 Only two operators are needed for this procedure a physician and a nurse. In the
isolation room respecting all the preventive measures for respiratory, droplet and
contact isolation provided by the World Health Organization for the nCoV-19 outbreak.

The ultrasound probe and the tablet were put in two different sterile, plastic probe
and tablet covers. The physician performs lung ultrasound using the wireless probe
and, therefore, entering in contact with the patient. The nurse holds the tablet
and is responsible to freeze and store images/videos, therefore not touching neither
the patient nor anything else within the room.

At the end of the procedure, the tablet and probe can be sterilized in a dedicated
area and put into two new sterile plastic bags.

 The thorax needs to be scanned in the following 12 lung areas at bed-side: anterior
superior and inferior, lateral superior and inferior, posterior superior and inferior,
bilaterally. With informed consent obtained. Typically, the use of lung ultrasound
is routinely included in the management of patients with respiratory conditions 
and approved by the Ethic Committee.

Characteristic findings of lung ultrasound includes the following:

 * Thickening of the pleural line with pleural line irregularity;
 * B lines in a variety of patterns including focal, multifocal, and confluent;
 * Consolidations in a variety of patterns including multifocal small, non-translobar,
   and translobar with occasional mobile air bronchograms;
 * Appearance of A lines during recovery phase;
 * Pleural effusions are uncommon.

 Lung ultrasound documents signs suggestive for interstitial-alveolar damage showing
bilateral, diffuse pleural line abnormalities, subpleural consolidations, white 
lung areas and thick, irregular vertical artifacts.

 In their case report D. Buonsenso, A. Piano, F. Raffaelli, N. Bonadia, K. de Gaetano
Donati, F. Franceschi solemnly assert that in the evaluation of a suspected or confirmed
COVID-19 patient, particularly using pocket devices, has several implications.

Lung ultrasound reduces the number of health workers exposition to the COVID-19,
this is a primary point since last data are clearly showing that, in most involved
countries such as China and Italy, about 3 to 10% of infected patients are health
workers and hundreds of them are in quarantine, determining a serious problems of
health professionals’ shortage. In most hospitals, this is generating problems in
daily care of all patients (including non COVID-19 patients) and most nurses/doctors
are performing non-stop clinical rotations; also, some Italian regions are evaluating
the need to call back to work retired physicians.

Secondly, lung ultrasound can allow a first screening and discriminate low-risk 
patients. Third, **portable devices are definitely easier to sterilize due to smaller
surface areas.** Fourth, lung ultrasound can be performed on bed-side. Having this
opportunity would allow a safer discharge of patients.

Fifth advantage, lung ultrasound is radiation free and can be performed every 12
to 24 hours and would allow a close monitor of clinical conditions and also detect
very early change in lung involvement. Sixth, lung ultrasound can be easily performed
in the outpatient. (read more on the advantages **[COVID-19 Lung Ultrasound](https://sifsof.com/product-category/covid-19/lung-ultrasound/)**).

References: [Findings of lung ultrasonography of novel corona virus pneumonia during the 2019–2020 epidemic](https://link.springer.com/article/10.1007/s00134-020-05996-6),
[Point-of-Care Lung Ultrasound findings in novel coronavirus disease-19 pnemoniae: a case report and potential applications during COVID-19 outbreak](https://www.europeanreview.org/wp/wp-content/uploads/2776-2780.pdf),
[Can Lung US Help Critical Care Clinicians in the Early Diagnosis of Novel Coronavirus (COVID-19) Pneumonia?](https://pubs.rsna.org/doi/10.1148/radiol.2020200847).

![COVID-19 Lung Ultrasound](https://sifsof.com/wp-content/uploads/2020/03/COVID-
19-Lung-Ultrasound-1024x450.jpg)

![](https://sifsof.com/wp-content/uploads/2020/03/Cornoavirus-lung-ultrasound.png)

 * ![Color Doppler 3 in 1 Wireless Ultrasound Scanner SIFULTRAS-3.31 main](https://
   sifsof.com/wp-content/uploads/2019/10/SIFULTRAS-3.31-main-picture-300x300.jpg)
 * Color Doppler 3 in 1 Wireless Ultrasound Scanner SIFULTRAS-3.31
 * ![Wireless 3 in 1 Ultrasound Scanner SIFULTRAS-3.3 Triple Headed: Convex, Linear
   and Cardiac Probe main pic](https://sifsof.com/wp-content/uploads/2019/09/SIFULTRAS-
   3.3-main-picture-1-300x300.jpg)
 * 3 in 1 Ultrasound Scanner SIFULTRAS-3.3 Triple Headed: Convex, Linear and Cardiac
 * ![wireless ultrasound scanner](https://sifsof.com/wp-content/uploads/2023/06/
   SIFULTRAS-5.42-double-head-wireless-ultrasound-300x300.webp)
 * Color Double Head Wireless Ultrasound Scanner SIFULTRAS-5.42 FDA

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_Disclaimer: Although the information we provide is used by different doctors and
medical staff to perform their procedures and clinical applications, the information
contained in this article is for consideration only. SIFSOF is not responsible neither
for the misuse of the device nor for the wrong or random generalizability of the
device in all clinical applications or procedures mentioned in our articles. Users
must have the proper training and skills to perform the procedure with each ultrasound
scanner device._

_The products mentioned in this article are only for sale to medical staff (doctors,
nurses, certified practitioners, etc.) or to private users assisted by or under 
the supervision of a medical professional.  _
