Modified Pulmonary Ultrasound To Evaluate Pulmonary Damage After Treatment Of CCVID-19 Pneumonia

Objective:To evaluate the difference in ultrasonographic manifestations of pulmonary lesions in patients cured of COVID-19 pneumonia and Not COVID–19CAP.Method: A total of 24 patients with COVID-19 pneumonia and 32 patients with Not COVID–19 CAP who were continuously living in China were selected.Modified pulmonary ultrasound,HRCT,pulmonary function examination and serum marker detection of pulmonary fibrosis were prospectively used to evaluate the lung damage half a year after recovery,and the difference of lung damage between the two groups was evaluated.Results: 1.Among the 24 patients with COVID-19 pneumonia recovered,the improved pulmonary ultrasound examination showed that the abnormal ultrasound signs occurred in the lower BLUE spot in both lungs,the diaphragmatic spot and the BLUE spot behind the right lung.2.The incidence of irregular pleural line,scattered line B and fused line B in patients with COVID-19 pneumonia was higher than that in patients with NOT COVID-19 CAP,P > 0.05.3.In COVID-19 patients cured of pneumonia,the correlation between the modified pulmonary ultrasound score and HRCT Warrick score was 0.766(P < 0.001).In patients cured of NOT COVID-19 CAP,the correlation between the modified pulmonary ultrasound score and HRCT Warrick score was 0.917(P < 0.001).4.The modified pulmonary ultrasound score of COVID-19 patients cured of pneumonia was higher than that of NOT COVID-19 CAP patients cured,P < 0.001.The HRCT score of COVID-19 patients with pneumonia was higher than that of patients with NOT COVID-19 CAP,P < 0.001.In terms of serum markers of pulmonary fibrosis,KL-6,SP-A,SP-B,CXCL13,CXCL18 and other indexes in patients with COVID-19 pneumonia were higher than those in patients with NOT COVID-19 CAP(P < 0.05),while there was no difference in MMP indexes between the two groups.In terms of lung function indexes,FVC,FEV1 and MVV of patients with COVID-19 pneumonia were not different from those of patients with NOT COVID-19 CAP.Conclusion: 1.Improved pulmonary ultrasound can be used to evaluate patients with cured pneumonia,and it has a good correlation with HRCT.2.The pulmonary damage of COVID-19 cured patients with pneumonia was more severe than that of Non COVID–19 CAP cured patients,so regular follow-up observation should be performed for the former.Objective: To evaluate the follow-up effect of modified pulmonary ultrasonography in COVID-19 cured patients with pulmonary lesions.Method: A total of 24 patients with COVID-19 pneumonia who were continuously resident in China were selected and divided into mild 7 cases,moderate 12 cases and severe 5 cases according to the first high-resolution CT(HRCT)examination on admission.Six months after cure,the improved pulmonary ultrasound,HRCT,lung function examination and serum marker detection of pulmonary fibrosis were prospectively used to evaluate the lung damage,and the correlation and consistency between the improved pulmonary ultrasound and the above methods were evaluated.Results: 1.Follow-up after six months of COVID-19 treatment with modified pulmonary ultrasound showed that the lung damage in the mild group was significantly different from that in the moderate and severe groups(all P < 0.05),while there was no difference between the moderate and severe groups.HRCT follow-up of COVID-19 six months after cure showed significant difference in lung damage between the mild group and the severe group(P < 0.05),while there was no difference between the moderate group and the mild/severe group.2.The consistency between the improved lung ultrasound and HRCT(Kappa=0.778,P < 0.001),the consistency between the improved lung ultrasound and lung function examination(Kappa=0.059,P=0.394),and the consistency between HRCT and lung function examination(Kappa=0.091,P=0.285).3.There was a positive correlation between the score of modified lung ultrasound and HRCT Warrick score(r=0.766,P < 0.001).4.The modified lung ultrasound scores were negatively correlated with FVC and FEV1(r=-0.586,-0.702,all P < 0.005),but not with MVV,while the HRCT Warrick scores were not correlated with FVC,FEV1 and MVV.There was no correlation between the modified pulmonary ultrasound score,HRCT Warrick score and serum markers of pulmonary fibrosis.5.Six months after cure,most of the patients were negative in serum Ig G antibody,and there was no significant difference in pulmonary Buda score and HRCT Warrick score between negative and positive patients(all P > 0.05).Conclusion: 1.Patients with COVID-19 pneumonia still have different degrees of lung damage after recovery.2.Modified pulmonary ultrasound can be used as a priority for the evaluation of lung damage in the follow-up of COVID-19 cured patients with pneumonia,reducing the use of HRCT,and providing favorable evidence for further clinical diagnosis and treatment.