Ultrasound in Times of COVID-19

ICU Management & Practice, Volume 20 – Issue 1, 2020

The potential clinical utility of ultrasound modalities in the COVID-19 patient, the limitations, evidence base and governance over point of care ultrasound images during a pandemic and a discussion on whether the hype surrounding Lung Ultrasound (LUS) is justified.

Introduction

The use of ultrasound outside radiology has already become well established within many of the acute specialties, such as critical care and emergency medicine. Critical care ultrasound (CCUS) takes place at the point of care. It has many advantages:

• Non-invasive
• Negates the need to expose the patient to ionising radiation
• Associated with minimal logistical disruption, being performed at the bedside
• Repeatable (Huang et al. 2020)
• Quick to perform
• Low cost

Many of these qualities have become particularly relevant in the current climate of the COVID-19 pandemic we are facing, where moving patients with COVID-19 around the hospital, in order to perform imaging studies, comes with significant risks. Sending patients elsewhere in order to perform other imaging studies removes them from a place of isolation/infection quarantine, to non-infected areas. This places other staff, patients and the general public at significant risk of contamination.

There has been much fixation with COVID-19 being a disease solely affecting the lungs. In this article, we will discuss the potential clinical utility of the other ultrasound modalities in the COVID-19 patient. We will also discuss the limitations, evidence base and governance over point of care ultrasound images during a pandemic. Indeed, is all of the hype surrounding Lung Ultrasound (LUS), justified, as it has certainly received the limelight?