Advanced Ultrasound in Diagnosis and Therapy ›› 2020, Vol. 4 ›› Issue (2): 79-83.doi: 10.37015/AUDT.2020.200020

• Original Research • Previous Articles     Next Articles

Transthoracic Ultrasound Evaluation of Pulmonary Changes in COVID-19 Patients During Treatment Using Modified Protocols

Guorong Lyu, MDa,b,*(), Ying Zhang, MDa, Guoliang Tan, MDa   

  1. a Department of Ultrasound, Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
    b Department of Clinical Medicine, Quanzhou Medical College, Quanzhou, Fujian, China
  • Received:2020-04-01 Online:2020-06-30 Published:2020-04-18
  • Contact: Guorong Lyu, MD,


Objective: To investigate the feasibility of evaluating imaging changes pre-and post-treatment in Corona Virus Disease 2019 (COVID-19) patients by transthoracic pulmonary ultrasound.
Methods: A total of 8 patients diagnosed with severe or critical COVID-19 pneumonia were recruited, and then ultrasound scanning was performed to evaluate the pulmonary imaging changes pre- and post-treatment based on a modified ultrasonic Buda protocol. The correlation between chest high resolution computed tomography (HRCT) Warrick scoring and ultrasonic results was analyzed.
Results: The main manifestations of ultrasonic imaging in severe or critical COVID-19 patients were: (1) pleural thickening (8/8), blurry or irregular fragmentation (6/8), and discontinuous fragmentation (4/8); (2) pulmonary lesions: B-line sign (2/8), partial or complete fusion of B-line (white lung) (8/8), and pulmonary or subpleural small consolidation (C-line sign) in severe cases (3/8); and (3) rarely, pleural effusion or pulmonary gas cyst (1/8). The imaging results, which were evaluated followed by a modified Buda transthoracic pulmonary ultrasound protocol, were highly correlated with HRCT Warrick scoring (r = 0.715, P < 0.05). Meanwhile, both ultrasonic and HRCT imaging results were significantly improved with progressive COVID-19 treatment (P < 0.05).
Conclusion: The ultrasonic pulmonary imaging of COVID-19 patients manifested several characteristics. The modified Buda transthoracic pulmonary ultrasound protocol could be an alternative method to evaluate the pulmonary lesions in COVID-19 patients.

Key words: COVID-19; Ultrasound; Lung; Pulmonary edema; High resolution computed tomography