key: cord-1048396-588ilpvc
authors: Buda, Natalia; Cylwik, Jolanta; Kwiecińska, Renata
title: Similarity of Lung Ultrasound Image in Patients with COVID-19 and COVID-19–like Illnesses
date: 2021-03-01
journal: Am J Respir Crit Care Med
DOI: 10.1164/rccm.202008-3080im
sha: 3b34bcd86b94e42f7ea1d0d3e16d6a9704a9d969
doc_id: 1048396
cord_uid: 588ilpvc

nan

. "COVID-19-like" diseases, as shown on computed tomography (CT) and LUS scans. Case 1: In the CT scan, arrows point to subpleural ground-glass opacities with crazy-paving pattern and consolidations being formed. Ultrasound scans visualize irregular subpleural consolidations (left and right arrows). The down arrows indicate a blurred, fragmented pleural line. Case 2: In the CT scan, arrows point to ground-glass opacities and consolidations. An ultrasound scan with a convex transducer shows visible B-line artifacts (right arrows); a blurred, fragmented pleural line (down arrows); and irregular subpleural consolidation (left arrow). An ultrasound scan with a linear transducer shows small, oval subpleural consolidations (left arrows) and an irregular pleural line (down arrows). Case 3: in the CT scan, arrows point to large ground-glass opacities and consolidations. An ultrasound scan with a convex transducer shows a visible blurred, fragmented pleural line (down arrows) and white lung (right arrows); an ultrasound scan with a linear transducer shows a hypoechoic pleural line (down arrows), subpleural consolidation (left arrows), and C-line artifacts (right arrow). COVID-19 = coronavirus disease; LUS = lung ultrasound.

Some patients with coronavirus disease (COVID-19) develop interstitial pneumonia (1). Consistent with available reports, imaging diagnostics involve high-resolution computed tomography of the chest and lung ultrasound (2) (3) (4) (5) . Imaging findings (high-resolution computed tomography of the chest and lung ultrasound) are typical of bilateral interstitial lesions. The gold standard for identifying the etiology of interstitial inflammatory lesions secondary to COVID-19 is the result of the RT-PCR test. This report presents patients with COVID-19 and clinical cases in which imaging findings (ultrasound and computed tomography) may be qualified as "COVID-19-like," yet extended laboratory, viral, and microbiological diagnostic procedures reveal a different etiology of acute symptoms (Figures 1 and 2) .

B-line artifacts with concomitant subpleural lesions on lung ultrasound are found in the case of noncardiogenic pulmonary edema (contusion of the lung, acute respiratory distress syndrome, viral pneumonia, etc.) (3, 5) . In the context of the COVID-19 pandemic, it is likely that a patient with fever, cough, and dyspnea may be infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, many other respiratory diseases may cause similar symptoms. Diagnostic imaging may indicate an interstitial lesion in the lungs with high sensitivity but does not differentiate the etiology. n 

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