To evaluate the value of bedside pulmonary ultrasonography in evaluating the extent of pulmonary lesions in patients with coronavirus disease 2019 (COVID-19).

From January to March 2020, a total of 74 patients with COVID-19 confirmed by nucleic acid test at Shenzhen Third People's Hospital underwent bedside lung ultrasonography. According to the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7) released by National Health Commission/State Administration of Traditional Chinese Medicine in 2020, the patients were divided into a critical group (n=15), a severe group (n=22), and a mild group (including the common type, n=37). Oxygenation index values, days of mechanically assisted ventilation, lung sonography characterristics, and lung score were recorded on the day of the ultrasound examination. One-way ANOVA was used to test the oxygenation index values, assisted respiration days, and lung score among the three groups. Pearsons χ² test was used to analyze the characteristics of lung ultrasonography. Independent sample rank sum test was used to compare sonographic characteristics. The correlations between lung scores and oxygenation index values and assisted respiration days were analyzed by the Pearson bivariate method.

There was a significant difference in oxygenation index values [(220.96±104.65) mmHg vs (296.00±78.95) mmHg vs (393.78±118.97) mmHg, 1 mmHg=0.133 kPa, F=18.520, P＜0.001], assisted respiration days [(19.27±11.91) d vs (8.77±6.73) d vs (2.92±5.43) d, F=25.483, P＜0.001], and lung scores among the three groups [(20.6±4.98) vs (12.77±5.54) vs (4.54±3.43), F=73.894, P＜0.001] among the three groups. The main features of lung ultrasonography in the critical group were pleural thickening and discontinuity (100%, 15/15) , a large amount of consolidation (80%, 12/15), and pericardial effusion (13%, 2/15). There was a significant difference in the percentages of patients with a large amount of consolidation and pericardial effusion between the critical group and the severe group [80% (12/15) vs 32% (7/22), Z=3.170, P=0.005; 13% (2/15) vs 0, Z=2.439, P=0.044] and mild group [80% (12/15) vs 5% (2/22), Z=5.369, P＜0.001; 13% (2/15) vs 0, Z=2.668, P=0.023]. Lung scores had a significant correlation with oxygenation index values and assisted respiration days in patients with COVID-19 (r=-0.62, P＜0.01; r=0.67, P＜0.01, respectively).

Bedside lung ultrasound could be used to evaluate the extent of pulmonary lesions in patients with COVID-19, which may be helpful for clinical diagnosis and treatment.