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Lung Ultrasound Reveals Distinct Findings in COVID-19 Patients

By MedImaging International staff writers
Posted on 27 Jul 2020

Image: Multiple confluent B-lines (arrows), and thickened pleural line (arrowheads) in an 82 year old COVID-19 patient (Photo courtesy of AJR)

Typical lung ultrasound findings in patients with COVID-19 included B-lines, pulmonary consolidation, and a thickened pleural line, according to a new study.

Researchers at Beijing Ditan Hospital (BJDTH; China) and Peking University (Beijing, China) conducted a study involving 28 consecutive COVID-19 patients (50% men; mean age 60 years), as determined by a positive reverse transcriptase polymerase chain reaction (PCR) test during March 2020, in order to investigate lung ultrasound imaging findings and features, and their relationship with the duration of symptoms and disease severity.

The results revealed that all 28 patients had positive lung ultrasound findings, with the most common findings being B-lines (100%), consolidation (67.9%), and a thickened pleural line (60.7%). The thickened pleural line was observed in a higher percentage of patients with a longer duration of the disease than in those with a shorter duration, and pulmonary consolidations were more common in severe and critical cases than in moderate cases. The study was published on July 23, 2020, in the American Journal of Radiology.

“Lung ultrasound can provide an objective evaluation to identify which patients with COVID-19 have the severe and critical forms of the disease. This capability is particularly important in situations in which chest CT is not available, such as in isolation wards and ICUs,” concluded lead author Yao Zhang, MD, of BJDTH, and colleagues. “Although portable radiography could be just as useful as ultrasound in terms of evaluation of consolidation, a portable, handheld ultrasound system further minimizes the number of health care workers and medical devices exposed to COVID-19, compared with radiography.”

B-lines are caused by the reverberation of the ultrasound beam between slightly decreased alveolar air and increased interstitial fluids. They are visualized as multiple vertical echogenic reverberation artifacts extending from the lung surface, but cannot be used to differentiate among different causes, such as cardiogenic edema, acute respiratory distress syndrome (ARDS), pulmonary fibrosis, or viral pneumonia. Pulmonary consolidation is visualized as tissue-like hypoechoic regions, which reflect highly reduced air flow and increased quantity of inflammatory cellular exudate. A thickened pleural line on ultrasound is thought to reflect pulmonary fibrosis.

Related Links:
Beijing Ditan Hospital
Peking University

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64 (!!!!! 7309.9136352539): select jos_twitters.link from jos_twitters where cat=10

65 (94.175338745117): select jos_facebook.link from jos_facebook where cat=10

66 (36.001205444336): select jos_google_plus.link from jos_google_plus where cat=10

67 (31.948089599609): select jos_linkedin.link from jos_linkedin where cat=10

68 (35.04753112793): SELECT fid FROM jos_deeppockets WHERE id=294783661 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294783661 AND published='1' LIMIT 1

69 (35.04753112793): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=214 ORDER BY `ordering`

70 (!!!!! 2027.0347595215): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294783661 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (402.92739868164): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294783661 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (44.107437133789): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (691.89071655273): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (158.07151794434): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (!!!!! 1250.9822845459): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (!!!!! 3954.1721343994): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (674.00932312012): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (221.96769714355): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (313.99726867676): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (419.13986206055): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (149.01161193848): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (102.99682617188): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (97.036361694336): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (845.90911865234): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294783661 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (351.90582275391): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294783661 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (239.13383483887): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (!!!!! 2182.9605102539): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (173.09188842773): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (!!!!! 2717.0181274414): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (53.882598876953): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 3864.049911499): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

105 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

106 (56.982040405273): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294783661 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (507.83157348633): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294783661 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 3821.849822998): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

109 (!!!!! 4734.0393066406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

110 (916.95785522461): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294783661 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (578.16505432129): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294783661 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (619.88830566406): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (371.21772766113): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

115 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

116 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

117 (43.153762817383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

118 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

119 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

120 (161.88621520996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

121 (195.98007202148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

122 (283.95652770996): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 40089.845657349): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (755.07164001465): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294783661 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294783661 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 14520.168304443): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (130.17654418945): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (!!!!! 2157.9265594482): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (51.021575927734): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (48.87580871582): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (32.901763916016): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (301.12266540527): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (36.954879760742): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (32.901763916016): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (589.84756469727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (396.9669342041): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (48.87580871582): SELECT name FROM jos_deeppockets WHERE id=214

138 (30.994415283203): SELECT name FROM jos_deeppockets WHERE id=214

139 (602.96058654785): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (509.97734069824): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (!!!!! 5199.9092102051): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

142 (92.029571533203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

143 (!!!!! 29520.034790039): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 3730.7739257812): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294783661 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (944.13757324219): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294783661 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 1049.9954223633): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (103.95050048828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 2271.8906402588): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

149 (125.88500976562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

150 (!!!!! 3494.9779510498): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (92.029571533203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

152 (154.01840209961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

153 (!!!!! 5445.9571838379): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294783661 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294783661 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (95.129013061523): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=214 or channel_id is null)

155 (33.855438232422): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=214 or channel_id is null)

156 (35.04753112793): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 3342.1516418457): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

158 (113.96408081055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294783661 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294783661 AND published='1' LIMIT 1

159 (893.11599731445): select jos_twitters.link from jos_twitters where cat=10

160 (50.067901611328): select jos_facebook.link from jos_facebook where cat=10

161 (33.140182495117): select jos_google_plus.link from jos_google_plus where cat=10

162 (32.186508178711): select jos_linkedin.link from jos_linkedin where cat=10

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