lung ultrasound covid-19 coronavirus

Lung Ultrasound Progression of COVID-19 Coronavirus

This post shows the lung ultrasound progression of an emergency medicine physician from Spain, Dr. Yale Tung Chen who was diagnosed with COVID-19 (Coronavirus) as he documented his illness day-by-day on twitter. You can follow him on twitter here: @yaletung

The first day he documented it was March 9th, 2020 with normal ultrasound and it progressed to interstitial edema (B-lines), pleural thickening, and pleural effusions in a matter of days. He is still documenting residual findings of interstitial edema (B-lines) 2 weeks after, just showing how long the COVID-19 can affect the lungs.

I think this is a great case to follow and understand what may be going on in the lungs of patients being discharged from the emergency department or urgent care. After reviewing this case I was surprised how quick the onset is and how long it takes for COVID-19 to resolve.

I compiled Dr. Yale Tung Chen’s daily ultrasound tweets so you can see the progression and also put a summary of the lung ultrasound findings on the left side.

Daily Lung Ultrasound Tweets from Dr. Yale Tung Chen:

DAY 1 of COVID-19

  • Normal Findings
  • A-profile
  • No Pleural Effusions

DAY 2 of COVID-19

  • B-lines in Dependent Lung Fields (costodiaphragmatic angles)
  • Small Bilateral Pleural Effusions
  • Thickened (echogenic) Pleural Line

DAY 3 of COVID-19

  • Similar to Day 2
  • B-lines in Dependent Lung Fields (costodiaphragmatic angles)
  • Small bilateral pleural effusions
  • Thickened (echogenic) Pleural Line

DAY 4 of COVID-19

  • B-lines in Dependent Lung Fields (costodiaphragmatic angles)
  • Small bilateral pleural effusions
  • Thickened (echogenic) Pleural Line
  • Subpleural Consolidations

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DAY 5 of COVID-19

  • Increasing B-lines that look confluent
  • Pleural Effusions Resolve
  • Thickened (echogenic) Pleural Line
  • Increase in Subpleural Consolidations

DAY 6 of COVID-19

  • Continued Significant Amount of B-lines
  • Thickened (echogenic) Pleural Line
  • Subpleural Consolidations Resolving

DAY 7 of COVID-19

  • Decrease in Amount of B-lines
  • Thickened (echogenic) Pleural Line
  • Subpleural Consolidations Resolved

DAY 8 of COVID-19

  • Right Lung Improvement/Resolution
  • New B-lines in Left Lateral Side

DAY 9 of COVID-19

  • Focal B-lines On Left Lower and Lateral Side

DAY 10 of COVID-19

  • Continued focal B-lines in the Left Lung
  • Now also with Right Lung Involvement Showing B-lines

DAY 11 of COVID-19

  • Continued Focal B-lines in both lungs
  • Bilateral subpleural consolidations
  • Thickened Pleura

DAY 12 of COVID-19

  • Subpleural consolidations resolving
  • Thickened Pleura
  • Continued Focal B-lines

DAY 13 of COVID-19

  • Subpleural consolidations resolving
  • Thickened Pleura
  • Continued scattered B-lines

DAY 14 of COVID-19

  • Decreased Thickening Pleura
  • Continued scattered B-lines

DAY 15 of COVID-19

  • Similar to Day 14
  • Decreased Thickening Pleura
  • Continued scattered B-lines

DAY 16 of COVID-19

  • Decreased Thickening Pleura
  • Improving B-lines Bilaterally

DAY 17 of COVID-19

  • Resolving B-lines
  • Improved pleural thickness

DAY 18 of COVID-19

DAY 19 of COVID-19

DAY 20 of COVID-19

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SAM

Awesome!

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