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Uncorrected Proof. Available online 4 December 2024
Potential role of lung ultrasonography in outpatient follow-up of patients with COVID-19. A systematic review
Papel de la ecografía pulmonar en el seguimiento ambulatorio de pacientes tras COVID-19. Revisión sistemática de la literatura
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F.N. Romeroa,b,
Corresponding author
f.navarroromero@gmail.com

Corresponding author.
, J.O. Sierraa, M.D. Martín Escalantea
a Servicio de Medicina Interna, Hospital Costa del Sol, 29603 Málaga, Spain
b Facultad de Medicina, Universidad de Málaga, 29010 Málaga, Spain
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Tables (2)
Table 1. Thoracic ultrasound characteristics and results in published studies.
Table 2. Quality of the ultrasound technique and operator observation.
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Abstract
Introduction and aim

Currently, the usefulness of lung ultrasound in the follow-up of patients after hospital discharge for SARS-CoV-2 pneumonia is not well known. The main objective of this systematic review is to investigate the persistence of alterations in lung ultrasound of patients who have had COVID-19 pneumonia.

Methods

A systematic review has been carried out following the PRISMA regulations in the PubMed, EMBASE, Web of Science and Google Scholar database from January 2020 to May 2023 using the combination of MeSH terms: “lung ultrasound”, “ultrasonography”, “lung alterations”, “persistence”, “follow-up”, “consequences”, “hospital discharge”, “COVID”, “COVID-19”, “SARS-CoV-2”. Studies were selected that described alterations in the lung ultrasound of patients after having suffered from COVID-19 pneumonia. The JBI Critical Appraisal Tools were used to assess the risk of bias of the studies. No meta-analysis techniques were performed, the results being compared narratively.

Results

From two to six months after COVID-19 pneumonia, pulmonary ultrasound abnormalities appear frequently and are proportional to the intensity of the initial episode. The most frequent anomalies are irregularities in the pleural line, the presence of B lines and/or subpleural consolidations, predominantly in the basal regions of the thorax. These findings seem to correlate with those of the chest CT.

Conclusions

Lung ultrasound offers technical and economic advantages that should be considered for the study of patients after hospital discharge for COVID-19.

Keywords:
Lung ultrasound
SARS-CoV-2
COVID-19
Consequences
Abbreviations:
WHO
ARDS
CT
ICU
ILD
IMV
NIMV
Resumen
Introducción y objetivo

Actualmente no se conoce bien la utilidad de la ecografía pulmonar en el seguimiento de los pacientes tras haber tenido una hospitalización por neumonía por SARS-CoV-2. El objetivo principal de esta revisión sistemática es investigar la persistencia de las alteraciones en la ecografía pulmonar de los pacientes que han tenido una neumonía COVID-19.

Métodos

Se ha realizado una revisión sistemática siguiendo la normativa PRISMA en la base de datos PubMed, EMBASE, Web os Science y Google Scholar desde enero del 2020 hasta mayo del 2023 utilizando la combinación de términos MeSH: lung ultrasound, ultrasonography, lung alterations, persistence, follow-up, consequences, hospital discharge, COVID, COVID-19, SARS-CoV-2. Se seleccionaron estudios que describieran alteraciones en la ecografía pulmonar de pacientes tras haber padecido una neumonía COVID-19. Se empleó la JBI Critical Appraisal Tools para evaluar el riesgo de sesgos de los estudios. No se realizaron técnicas de metaanálisis, siendo los resultados comparados narrativamente.

Resultados

De dos a seis meses después de la neumonía COVID-19, las alteraciones ecográficas pulmonares aparecen con frecuencia y son proporcionales a la intensidad del episodio inicial. Las anomalías más frecuentes son las irregularidades de la línea pleural, la presencia de líneas B y/o consolidaciones subpleurales, con predominio por las regiones basales del tórax. Estos hallazgos parecen correlacionarse con los de TC de tórax.

Conclusiones

La ecografía pulmonar ofrece unas ventajas técnicas y económicas que deben considerarse para el estudio de los pacientes tras el alta hospitalaria por COVID-19.

Palabras clave:
Ecografía pulmonar
SARS-CoV-2
COVID-19
Consecuencias

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