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
Awesome!
Thanks Dr. Ko!
[…] Chen YT. Lung ultrasound progression of COVID-19 coronavirus. 2020. Available at: https://www.pocus101.com/lung-ultrasound-progression-of-COVID-19-coronavirus/. Accessed August 17, […]
[…] Mar 25: Blog post summarizing @yaletung day to day experience with #COVID19 and doing self lung #POCUS exams… […]