Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 Articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Members & Subscribers
    • Benefits for CMA Members
    • CPD Credits for Members
    • Subscribe to CMAJ Print
    • Subscription Prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 Articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Members & Subscribers
    • Benefits for CMA Members
    • CPD Credits for Members
    • Subscribe to CMAJ Print
    • Subscription Prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Practice

Lung ultrasound findings in a 64-year-old woman with COVID-19

Adam Thomas, Greg Haljan and Anish Mitra
CMAJ April 14, 2020 192 (15) E399; DOI: https://doi.org/10.1503/cmaj.200414
Adam Thomas
Department of Critical Care Medicine (Thomas, Haljan, Mitra), University of British Columbia, Vancouver, BC; Island Health and Victoria General Emergency Department (Thomas), Victoria, BC; Department of Critical Care (Haljan, Mitra), Fraser Health, Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Greg Haljan
Department of Critical Care Medicine (Thomas, Haljan, Mitra), University of British Columbia, Vancouver, BC; Island Health and Victoria General Emergency Department (Thomas), Victoria, BC; Department of Critical Care (Haljan, Mitra), Fraser Health, Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anish Mitra
Department of Critical Care Medicine (Thomas, Haljan, Mitra), University of British Columbia, Vancouver, BC; Island Health and Victoria General Emergency Department (Thomas), Victoria, BC; Department of Critical Care (Haljan, Mitra), Fraser Health, Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Related Content
  • Responses
  • Metrics
  • PDF
Loading

A 64-year-old female health care worker developed a sore throat and productive cough, which were followed by nausea, vomiting and exertional dyspnea over 1 week in March 2020. She had no travel history or obvious sick contacts, but had interacted with patients in an outpatient clinic. She presented to the hospital after outpatient viral polymerase chain reaction (PCR) testing was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). On presentation she was febrile (38.7°C) and hypoxic (peripheral oxygen saturation [SpO2] 88% on room air), but appeared comfortable. Bibasilar crackles were heard on auscultation, and her chest radiograph showed bilateral infiltrates. A lung ultrasound was obtained when the patient presented to hospital, 10 days after symptom onset, and showed multifocal B-lines, pleural thickening and subpleural consolidation (Figure 1). The patient was admitted to hospital, received supportive care, and her volume status was tightly regulated. She initially required 6 L/min O2 via nasal cannula, but 6 days after admission, her oxygen requirements increased and she was intubated. At the time of this submission, she is stable but remains on mechanical ventilation.

Figure 1:
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 1:

Lung ultrasound of a 64-year-old female health care worker with no travel history, on day 10 after symptom onset. The lung point-of-care utrasound shows pleural thickening (right lung: green box); subpleural consolidation, also known as “skip lesion” (left upper lung: blue box); and multifocal B-lines (left lung: red box). The chest radiograph shows bilateral infiltrates.

Our images are similar to the lung ultrasound findings of Peng and colleagues regarding COVID-19.1 However, similar findings were also described in influenza A (H1N1) pneumonia.2 In 1 small study of patients with clinical and epidemiologic features compatible with COVID-19, PCR testing was shown to identify only 71% of subsequently confirmed cases compared with computed tomography of the lung.3 We propose that lung ultrasonography may be useful in the workup of patients with suspected COVID-19, even though differentiating between different causes of viral pneumonia is not possible.

An excellent primer by Dr. Daniel Lichtenstein describes an approach to lung ultrasonography and discusses the findings and associated differential diagnoses in more detail.4

Footnotes

  • Competing interests: None declared.

  • This article has been peer reviewed.

  • The authors have obtained patient consent.

References

  1. ↵
    1. Peng QY,
    2. Wang XT,
    3. Zhang LN
    Chinese Critical Care Ultrasound Study Group (CCUSG). Findings of lung ultrasonography of novel corona virus pneumonia during the 2019–2020 epidemic. Intensive Care Med 2020 Mar. 12 [Epub ahead of print]. doi: 10.1007/s00134-020-05996-6.
    OpenUrlCrossRef
  2. ↵
    1. Testa A,
    2. Soldati G,
    3. Copetti R,
    4. et al
    . Early recognition of the 2009 pandemic influenza A (H1N1) pneumonia by chest ultrasound. Crit Care 2012;16:R30.
    OpenUrlCrossRefPubMed
  3. ↵
    1. Fang Y,
    2. Zhang H,
    3. Xie J,
    4. et al
    . Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology 2020 Feb. 19 [Epub ahead of print]. doi: 10.1148/radiol.2020200432.
    OpenUrlCrossRef
  4. ↵
    1. Lichtenstein DA
    . Lung ultrasound in the critically ill. Ann Intensive Care 2014;4:1.
    OpenUrlCrossRefPubMed
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 192 (15)
CMAJ
Vol. 192, Issue 15
14 Apr 2020
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Lung ultrasound findings in a 64-year-old woman with COVID-19
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Lung ultrasound findings in a 64-year-old woman with COVID-19
Adam Thomas, Greg Haljan, Anish Mitra
CMAJ Apr 2020, 192 (15) E399; DOI: 10.1503/cmaj.200414

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Lung ultrasound findings in a 64-year-old woman with COVID-19
Adam Thomas, Greg Haljan, Anish Mitra
CMAJ Apr 2020, 192 (15) E399; DOI: 10.1503/cmaj.200414
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
    • Footnotes
    • References
  • Figures & Tables
  • Related Content
  • Responses
  • Metrics
  • PDF

Related Articles

  • Lung ultrasonography in a woman with COVID-19: This examination could be remote
  • Clarifying the role of lung ultrasonography in COVID-19 respiratory disease
  • Échographie pulmonaire d’une femme de 64 ans atteinte de la COVID-19
  • PubMed
  • Google Scholar

Cited By...

  • Point of care lung ultrasound is useful when screening for CoVid-19 in Emergency Department patients
  • Principes de soins cliniques aux patients atteints de la COVID-19 dans les unites medicales
  • Principles for clinical care of patients with COVID-19 on medical units
  • Clarifying the role of lung ultrasonography in COVID-19 respiratory disease
  • Lung ultrasonography in a woman with COVID-19: This examination could be remote
  • Google Scholar

More in this TOC Section

  • Penicillin allergy delabelling of patients at risk of sexually transmitted infections in primary care
  • Phthiriasis palpebrarum
  • Penicillin allergy delabelling in pregnancy
Show more Practice

Similar Articles

Collections

  • Article Types
    • Clinical Images
  • Topics
    • Critical & intensive care
    • Emergency medicine
    • Health services
    • Infectious diseases
    • Infectious diseases: COVID-19
    • Respiratory medicine

 

View Latest Classified Ads

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • CPD credits
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Advisory Panels
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions
  • Accessibiity
  • CMA Civility Standards
CMAJ Group

Copyright 2023, CMA Impact Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: cmajgroup@cmaj.ca

Powered by HighWire