• Intern Emerg Med · Nov 2022

    Observational Study

    Lung ultrasound in the follow-up of severe COVID-19 pneumonia: six months evaluation and comparison with CT.

    • Giulia Russo, Nicola Flor, Francesco Casella, Sonia Ippolito, Federica Leidi, Giovanni Casazza, Dejan Radovanovic, Federico Vezzulli, Pierachille Santus, and Chiara Cogliati.
    • Internal Medicine, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli Sacco, University of Milano, Via G.B. Grassi 74, 20157, Milan, Italy. giuliarusso02@gmail.com.
    • Intern Emerg Med. 2022 Nov 1; 17 (8): 226122682261-2268.

    AbstractWhile lung ultrasonography (LUS) proved to be a useful diagnostic and prognostic tool in acute phase of COVID 19 pneumonia, its role in detecting long-term pulmonary sequelae has yet to be explored. In our prospective observational study we assessed the potential of LUS in detecting the presence of computed tomography (CT) fibrotic-like changes after 6 months from COVID-19 pneumonia. Patients who were discharged with a diagnosis of severe COVID-19 pneumonia were enrolled. After 6 months from hospital discharge they underwent LUS, chest CT scan and pulmonary function tests. A logistic regression analysis was performed to assess the association between presence of symptoms, LUS score and diffusing capacity for carbon monoxide (DLCO) at 6-month after hospital discharge and CT scan fibrotic-like changes. A second logistic model was performed to assess the value of some predefined baseline factors (age, sex, worst PaO2/FiO2, ventilator support, worst CRP value, worst D-dimer value and worst LUS score during hospitalization) to predict fibrotic-like changes on 6-month CT scan. Seventy-four patients were enrolled in the study. Twenty-four (32%) showed lung abnormalities suitable for fibrotic-like changes. At multivariate logistic regression analysis LUS score after 6 months from acute disease was significantly associated with fibrotic-like pattern on CT scan. The second logistic model showed that D-dimer value was the only baseline predictive variable of fibrotic-like changes at multivariate analysis. LUS performed after 6 months from severe COVID-19 pneumonia may be a promising tool for detection and follow-up of pulmonary fibrotic sequelae.© 2022. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).

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