Lung Ultrasound Findings in COVID-19 Pneumonia
A 76-year-old otherwise healthy man was delivered by ambulance to the emergency room with a 4-day history of fever (up to 39°C), a dry cough, and diarrhea. The main clinical findings were tachypnea and respiratory insufficiency (SpO2 93%, 15 L oxygen with reservoir mask). Laboratory tests detected elevated concentrations of C-reactive protein (86 mg/L) and lactate dehydrogenase (431 U/L); the procalcitonin level was normal. Pulmonary sonography at the bedside revealed areas of jagged fragmentary pleural line with partially confluent B lines, particularly in the upper anterior portion of the left lung; lung sliding was present (Figure a). In adjacent lung areas the sonographic findings were normal. A consolidation with liver-like echo texture and air bronchogram was visualized in the right costophrenic angle (Figure b). A pleural effusion was also seen. This pattern on pulmonary sonography is currently considered indicative of COVID-19 viral pneumonia. Computed tomography confirmed the morphological findings, with ground-glass opacities concentrated in the left upper lobe and a consolidation in the right lower lobe. Despite intensive treatment the patient developed severe acute respiratory distress syndrome and multiorgan failure. He died on day 14 after admission.
Dr. med. Mathias Schmid, München Klinikum Bogenhausen, München, firstname.lastname@example.org
Conflict of interest statement: The author declares that no conflict of interest exists.
Translated from the original German by David Roseveare.
Cite this as: Schmid, M: Lung ultrasound findings in COVID-19 pneumonia.
Dtsch Arztebl Int 2020; 117: 335. DOI: 10.3238/arztebl.2020.0335
Medizinische Klinik - Intensivmedizin und Notfallmedizin, 202010.1007/s00063-020-00740-w