My Authors
Read all threads
The largest study of ultrasound for #COVID19 to date (that I'm aware of) - retrospective, 30 pts with COVID confirmed via PCR, who underwent both lung US and CT

Lung US was compared to CT which was used as the reference standard

#POCUSforCOVID

thieme-connect.de/products/ejour…

1/
All US scans were performed at the bedside by a single physician
-6 region scan per hemithorax (anterior, lateral, posterior divided into upper and lower regions)
-scanning in BOTH longitudinal and transverse
-used BOTH convex and linear probes
-5-8 min per scan

2/
Yet *another* scoring system:
0 pt: normal pleural line, A lines, <3 B lines
1 pt: >3 B lines
2 pt: coalescent B lines
3 pt: consolidation

Total score summed up (0-36 pt):
-none: 0 pt
-mild: 1-7 pt
-moderate: 8-18 pt
-severe: 19+ pt

3/
CT was scored via a different mechanism, where the two lungs were divided into 20 equal segments (each segment 5% of the total):
-none: 0%
-mild: 5-30%
-moderate: 31-50%
-severe: 51+%

4/
Clinically, 50% had moderate illness, 37% had severe illness, 13% had critical illness, but this is never defined

Unfortunately, the authors never analyze the relationship between imaging findings and clinical severity

5/
-3 of 30 pts had no findings on lung US
-27 of 30 pts had lung US findings: all had B-lines
-6 had consolidation
-3 had pleural thickening
-only 1 had a small pleural effusion
-22 with bilateral involvement
-lower lobes and posterior regions more commonly involved

6/
Diagnostic accuracy of lung US compared to reference standard of CT:
-Normal: 93%
-Mild: 77%
-Moderate: 77%
-Severe: 93%

9 cases had POOR correlation between US and CT

Common problem with US was poor imaging of apices of lungs, especially upper posterior (due to scapula)

7/
It's great to have more evidence on #POCUSforCOVID

Unfortunately, this isn't a true diagnostic test assessment of US for COVID, as all included pts were known to have COVID based on PCR testing

We still don't know what the "definition" of a positive lung US for COVID is

8/
Take homes:
-There is moderate agreement between lung US and chest CT findings - one of the issues with US was visualizing apical abnormalities
-10% of pts had normal lung US
-All pts with lung US findings had B lines, most abnormalities were found posteriorly and inferiorly

9/
Things we still need to learn about #POCUSforCOVID
-Best scanning protocol
-Learning curve and generalizability
-Actual test characteristics for COVID
-Definition of positive US
-Clinical significance of findings (severity, prognosis)

end/
Missing some Tweet in this thread? You can try to force a refresh.

Enjoying this thread?

Keep Current with Dan Kim

Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

Twitter may remove this content at anytime, convert it as a PDF, save and print for later use!

Try unrolling a thread yourself!

how to unroll video

1) Follow Thread Reader App on Twitter so you can easily mention us!

2) Go to a Twitter thread (series of Tweets by the same owner) and mention us with a keyword "unroll" @threadreaderapp unroll

You can practice here first or read more on our help page!

Follow Us on Twitter!

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3.00/month or $30.00/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!