COVID-19 pneumonia produces a heterogeneous array of clinical, biochemical, and radiological findings. Over the last few months of global hurry to optimize a testing strategy, it has been suggested that bedside point-of-care lung ultrasound may have a diagnostic role. We present 3 patients with RT-PCR nasopharyngeal swab-confirmed COVID-19 pneumonia, who had an admission plain chest film reported to be normal by a consultant radiologist, but with significant sonographic abnormalities on bedside ultrasound performed within 24 hours of the chest radiograph. Lung ultrasound may better correlate with the oxygen requirement and overall condition of the patient than chest radiographs – a pertinent consideration given the imminent advance of the pandemic into resource-poor zones where timely access to roentgenological imaging may be sparse.
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References
- Wang W, Xu Y, Lu R, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA 2020;323(18);1843-1844
- Li Y, Yao L, Li J, et al. Stability issues of RT-PCR testing of SARS-CoV-2 for hospitalized patients clinically diagnosed with COVID-19. J Med Virol. 2020;Mar 26.; doi: 10.1002/jmv.25786.[Epub ahead of print]
- Wong HYF, Lam HYS, Fong AH-T, et al. Frequency and Distribution of Chest Radiographic Findings in COVID-19 Positive Patients. Radiology 2019;Mar 27:201160. doi: 10.1148/radiol.2020201160. [Epub ahead of print]
- Weinstock MB, Echenique A, Russell JW, et al. Chest X-Ray Findings in 636 Ambulatory Patients with COVID-19 Presenting to an Urgent Care Center: A Normal Chest X-Ray Is no Guarantee. J Urgent Care Med. 2020;14(7);13-18
- Ai T, Yang Z, Hou H, et al. Correlation of Chest CT and RTPCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases Radiology 2020;Feb 26:200642. doi:10.1148/radiol.2020200642. [Epub ahead of print]
- Cellina M, Orsi M, Toluian T, et al. False negative chest X-Rays in patients affected by COVID-19 pneumonia and corresponding chest CT findings. Radiography 2020;26(3);e189-e194
- Ng M-Y, Lee EYP, Yang J, et al. Imaging Profile of the COVID-19 Infection: Radiologic Findings and Literature Review. Radiology: Cardiothoracic Imaging 2020;Feb 13. https://doi.org/10.1148/ryct.2020200034
- Peng QY, Wang X-T, Zhang L-N, et al. Findings of lung ultrasonography of novel corona virus pneumonia during the 2019 – 2020 epidemic. Intensive Care Med 2020;87;6
- https://www.acutemedicine.org.uk/what-we-do/training-andeducation/famus/famus-coronavirus-update/ (last accessed13/06/2020)
- Salehi S, Abedi A, Balakrishnan S, et al. Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. AJR 2020;215:1–7
- Smith MJ, Hayward SA, Innes SM, et al. Point-of-care lung ultrasound in patients with COVID-19 – a narrative review. Anaesthesia 2020 doi:10.1111/anae.15082
- Lu W, Zhang S, Chen B, et al. A Clinical Study of Noninvasive Assessment of Lung Lesions in Patients with Coronavirus Disease-19 (COVID-19) by Bedside Ultrasound. Ultraschall Med. 2020;Apr 15. doi: 10.1055/a-1154-879 (Epub ahead of print)
- Yasakuwa K, Minami T, et al. Point-of Care Lung Ultrasound Findings in Patients with Novel Coronavirus Disease (COVID-19) Pneumonia. Am J Trop Med Hyg. 2020;Apr 24. doi: 10.4269/ajtmh.20-0280. [Epub ahead of print]
