Prevalence and significance of pulmonary disease on lung ultrasonography in outpatients with SARS-CoV-2 infection

BMJ Open Respir Res. 2021 Aug;8(1):e000947. doi: 10.1136/bmjresp-2021-000947.

Abstract

Background: The majority of patients with SARS-CoV-2 infection are diagnosed and managed as outpatients; however, little is known about the burden of pulmonary disease in this setting. Lung ultrasound (LUS) is a convenient tool for detection of COVID-19 pneumonia. Identifying SARS-CoV-2 infected outpatients with pulmonary disease may be important for early risk stratification.

Objectives: To investigate the prevalence, natural history and clinical significance of pulmonary disease in outpatients with SARS-CoV-2.

Methods: SARS-CoV-2 PCR positive outpatients (CV(+)) were assessed with LUS to identify the presence of interstitial pneumonia. Studies were considered positive based on the presence of B-lines, pleural irregularity and consolidations. A subset of patients underwent longitudinal examinations. Correlations between LUS findings and patient symptoms, demographics, comorbidities and clinical outcomes over 8 weeks were evaluated.

Results: 102 CV(+) patients underwent LUS with 42 (41%) demonstrating pulmonary involvement. Baseline LUS severity scores correlated with shortness of breath on multivariate analysis. Of the CV(+) patients followed longitudinally, a majority showed improvement or resolution in LUS findings after 1-2 weeks. Only one patient in the CV(+) cohort was briefly hospitalised, and no patient died or required mechanical ventilation.

Conclusion: We found a high prevalence of LUS findings in outpatients with SARS-CoV-2 infection. Given the pervasiveness of pulmonary disease across a broad spectrum of LUS severity scores and lack of adverse outcomes, our findings suggest that LUS may not be a useful as a risk stratification tool in SARS-CoV-2 in the general outpatient population.

Keywords: COVID-19; imaging/CT MRI etc; pneumonia.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • COVID-19* / diagnostic imaging
  • Humans
  • Lung / diagnostic imaging
  • Lung Diseases / diagnostic imaging*
  • Lung Diseases / virology
  • Outpatients
  • Prevalence
  • Ultrasonography