What's new in lung ultrasound during the COVID-19 pandemic

The SARS-CoV-2 pandemic is undermining the ability of many advanced healthcare systems worldwide to provide quality care. COVID-19 is the disease caused by infection with SARS-CoV-2, a virus with specific tropism for the lower respiratory tract in the early disease stage. Computed tomography scans of patients with COVID-19 typically show a diffuse bilateral interstitial pneumonia, with asymmetric, patchy lesions distributed mainly in the periphery of the lung. In the context of a pandemic, rapid case identification, classification of disease severity and correct treatment allocation are crucial for increasing surge capacity. Overtriage to admission and to intensive care by clinicians working in the department of emergency medicine (ED) will overwhelm system capacity. Undertriage can lead to loss of life and cross infections. Similarly, selection of those patients most likely to respond to specific treatments and determining the response to treatment in the intensive care unit (ICU) can conserve scarce resources. Lung ultrasound (LUS) is well known for its feasibility and high accuracy when used at the bedside for diagnosing pulmonary diseases. As the most striking manifestation of COVID-19 disease is in the pulmonary system, LUS performed by a trained and knowledgeable clinician may aid precisely in triage, classification of disease severity and treatment allocation in both the ED and the ICU. In this paper, we describe the use of LUS in treating patients with COVID-19.