To investigate the application of remote ultrasound in COVID-19 isolation ward.

Two patients with suspected COVID-19 were admitted to the isolation ward in critical condition. In the isolation ward, the intensive care unit (ICU) physician used ultrasound to evaluate patients’ heart, lung, abdomen, blood volume, and lower limb veins, guided by an ultrasound expert in remote.

(1) Under the guidance of the ultrasound expert, the ICU physician successfully performed ultrasound examination and gathered clear images. (2) The main manifestations of the patients’ lung lesions were multiple B3-lines in both lungs fused to “white lung” and pulmonary consolidation in the subpleural area. A small amount of effusion was observed in the bilateral costal diaphragmatic angle and left lower extremity vein thrombosis was found in patient No.1. Ultrasound was also used to assess the inner diameter and respiratory variability of the inferior vena cava for adjusting fluid supplementation. Patient No.1’s condition was severe with rapidly progressing pulmonary lesions. After treatment, ultrasound showed improvement in pneumonia and disappearance of pleural effusion and the left lower extremity vein thrombosis. (3) There was a high degree of consistency between ultrasound and chest computerized tomography (CT) findings in two patients.

The application of remote ultrasound can reduce the risk of cross-infection and save the personal protective equipment in the COVID-19 outbreak. Ultrasound experts can also provide real-time guidance for ICU physician to maintain a good quality of patient care and receive high-quality images for accurate diagnosis.

To investigate the value of lung ultrasound (LUS) in asymptomatic patients with confirmed COVID-19.

A retrospective analysis was performed on nine patients in a designated isolation hospital in Sanya from February 22nd, 2020 to February 23rd, 2020. All patients were confirmed with COVID-19 pneumonia by PCR test, but none had the typical symptoms of COVID-19. All patients first underwent LUS examination and then chest computed tomography (CT) scanning. The application value of LUS in asymptomatic confirmed patients with COVID-19 was evaluated, compared with chest CT which was regarded as the golden standard.

Among nine asymptomatic patients with COVID-19, there were two cases (22.22%) with abnormal ultrasonic manifestations, of which one (11.11%) showed a fusion B3-line in zone 5 of the right lung, and the other showed localized pulmonary consolidation in zone 6 of the left lung. The remaining seven cases (77.78%) showed no abnormal changes in LUS, but only clear pleura sliding sign and A-line. Chest CT showed abnormal changes in three cases (33.33%). Two of them (22.22%) showed flocculent high-density shadow at the base of both lungs (especially in the right lung), while the other case showed ground-glass opacity with thickened interlobular septal in the left lower lobe, involving the pleura. There were no abnormalities on chest CT of the remaining six cases (66.67%). The two (22.22%) LUS-positive patients were in complete coincidence with CT-positive patients. This study showed that the coincidence rate of the two examination methods was 88.89%. Taking chest CT as golden standard, the sensitivity, specificity, positive predictive value, negative predictive value, and Kappa value of lung ultrasound in the diagnosis of COVID-19 were 66.67%, 100%, 100%, 85.71%, and 0.727, respectively.

LUS can evaluate lung lesions in asymptomatic patients with COVID-19. Compared with chest CT, the diagnostic coincidence rate and diagnostic consistency of LUS are relatively higher. For this asymptomatic type of patient, ultrasound can be used as a diagnosis method, which can avoid the risk of radiation exposure in a short period of time. As a rapid and dynamic assessment method, LUS can cooperate with remote consultation to provide timely and accurate guidance for clinical diagnosis and treatment when necessary.