Lung Ultrasound (LUS) in COVID-19 Pneumonia: Usefulness in Two Atypical Cases

Eur J Case Rep Intern Med. 2020 Jun 26;7(8):001800. doi: 10.12890/2020_001800. eCollection 2020.

Abstract

Clinical experience and scientific articles have shown that patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be paucisymptomatic or asymptomatic at the time of diagnosis. In this paper, we will discuss two paucisymptomatic patients with blood tests suggestive for SARS-CoV-2 infection but with repeated negative nasopharyngeal swabs and without typical features of COVID-19 pneumonia on chest high-resolution computed tomography. In these cases, lung ultrasound helped to raise clinical suspicion of COVID-19 pneumonia and facilitate diagnosis.

Learning points: During the current COVID-19 pandemic, lung ultrasound (LUS) is being used extensively to evaluate and monitor lung damage in infected patients.Several patients have been described with negative PCR swabs who tested positive for SARS-CoV-2 in bronchoalveolar lavage fluid.Typical signs of interstitial pneumonia on LUS strongly indicate COVID-19 pneumonia, thus suggesting further investigation and invasive tests to confirm the diagnosis.

Keywords: Lung ultrasound (LUS); coronavirus disease 2019 (COVID-19); high-resolution computed tomography (HRCT); nasopharyngeal swab (NS); pneumonia.