Ultrasound assessment of SARS-CoV-2 pneumonia: a literature review for the primary care physician

Figures & data

Table 1. Synthesis of all the advantages and strengths of using ultrasound in COVID-19.

POCUS in COVID-19: points of interest

Low cost

Rapid

No exposure to radiations

Bedside (home-care)

Lung evaluation

Cardiac evaluation

Vessels evaluation

Figure 1. Bedside evaluation by a primary care physician of a patient with SARS-CoV-2 infection: B-lines at lung ultrasound appear as slightly hyperechoic bundles perpendicular to the hyperechoic pleural line.

Figure 2. Pleural effusion at lung ultrasound in a SARS-CoV-2 patient appears as an anechoic area (on the right region of the picture).

Table 2. Comparison of LUS and CT scan imaging in the assessment of COVID-19 patients.

	LUS	CT imaging
PRO	Good diagnostic performance Bedside evaluation Diagnosis of COVID-19 pneumonia at patient’s home Screening of complications (e.g. dehydration, heart involvement, etc.) Early screening of patients to refer to the hospital admission	High diagnostic accuracy High reproducibility Standardised protocols
CONS	Adequate training and experience Operator dependence No standardised protocols	Exposition to radiations Not available at patient’s home

Figure 3. The Italian network between primary care physicians and USCA doctors, who are activated by general practitioners to evaluate at home COVID-19 patients. The USCA doctors in presence of high risk factors, signs suggestive of respiratory failure and bilateral pneumonia could activate emergency system to require hospitalisation for COVID-19 patients in HUB dedicated medical centres.

Figure 4. Management of patients with SARS-CoV-2 in primary care. The presence of ultrasonographic signs of lung involvements or the presence of complications (for example, pleural effusions and cardiovascular alterations) in addition to clinical and SpO2 worsening could suggest the physicians to in-hospital management of patients.