As research efforts mature, different technologies and testing resources could be added into the process to get more information or to expand the view of the problem. If the target problem is vastly larger than originally anticipated, a complete redesign of the testing strategy may be what is called for.
In the case of testing for the physiological effects of Covid-19, researchers have employed standard medical diagnostic protocols from genetic/blood testing to biopsies to all available medical imaging devices) to gather all necessary data. These protocols independently and in concert provide the necessary answers leading to treatment, prevention and early detection.
Covid-19 Effects on the Lungs + Chest Ultrasound Written and presented by: Dr. Stephen Chagares (originally published May 7, 2020)
The Coronavirus has been shown to be very lethal to a subset of patients. What happens is that the virus is ingested into the mouth or nose, going down into the back of the throat (called the hypopharynx and the larynx) and then is breathed into the lungs themselves. The lungs are made of millions of little air SACS called alveoli, and the virus gets into these little layer sacks and adheres to the inner lining. That lining is what allows the interface between the blood and the air and the CO2 from the blood is given out. The oxygen from the air is given into the blood. That's how we breathe in oxygen and blow out CO2.When the virus gets in there and coats that surface, everyone creates some kind of reaction. One is an antibiotic body reaction- which is an immune response. The other thing that happens is a physical inflammatory response where the immune system automatically goes into defense mode and wants to go in and kill the virus. It senses it's there and sends in "defender" cells, and to most people, it can send the proper amount of little soldiers to do the job. But in a small percentage of patients, the body's internal reaction causes too much inflammation causing a large body of fluid to fill up in the alveoli (air sacs) in the lungs. This stops the ability for oxygen to fuse through those air sacks to get oxygen into the entire body, include vital organs like the heart, the brain, the liver etc. Without oxygen, this could result serious problems like heart and liver failure (and other such symptoms).To visually identify this problem, existing technologies have to be tuned to track and monitor cardio-pulmonary performance. Chest x-rays or CT/catscans are available and are widely used now- but carry a number of key issues when it comes to regular chest monitoring. Often normal chest X rays are going to miss this because radiation itself will go through the lung tissue and the fluid and it may not show anything too specific. And then a cat scan may show something totally different where you can see how both lungs are all inflamed and have fluid in them.
WHAT ARE B LINES? By: Dr. Pierre Kory
The analysis of lung artefacts has gained increasing importance as markers of lung pathology. B-line artefact (BLA), caused by a reverberation phenomenon. (source link: NCBI/NIH) B-lines in COVID-19 pneumonia are visualized in all their possible forms. We may describe COVID-19 pneumonia as a storm of clusters of B-lines, both in separate and coalescent forms, sometimes giving the appearance of a shining white lung. They can arise from one point of the pleural line and from small peripheral consolidations and spread down like rays maintaining their brightness until the edge of the screen without fading. These artifacts represent the typical signs of the disease, but can be also observed in other interstitial diseases of various etiologies (Source link: The Ultrasound Journal/Springer)
“When conducting lung ultrasound scanning, you look for signs of B-LINES. The more B lines you have equals a bad lung ultrasound score – indicating a high risk of deterioration. For any treatment protocol, if a patient whose lung ultrasound scan was getting worse, I might want to start escalating my therapy.” – Dr. Philippe Kory, MATH+
HOW USEFUL IS LUNG SCANNING FOR COVID-19? For decades, the popularity of ultrasound technology has joined the front lines in identifying and diagnosing disorders from CANCER TUMORS (PROSTATE, BREAST, SKIN, THYROID, MELANOMA etc), musculoskeletal issues and even transcranial (brain) disorders.
With the current pandemic, clinicians worldwide have been earmarking how identifying issues in the lungs (and the cardiopulmonary area) through the use of ultrasound equipment can be quite helpful in monitoring, screening, scanning and tracking pulmonary vulnerabilities and infections that may require follow-up testing for Coronavirus.
Adding to the arsenal of diagnostic solutions for the Covid-19 respiratory pathogen, the LUNG (or CHEST) ULTRASOUND is making great strides in triage facilities and bedside monitoring. A growing community of European health specialists are joining a procedural movement to "replace" the dependency on stethoscopes with portable ultrasound use to check a patient's immediate cardiopulmonary condition. For Covid-positive patients, today's ultrasound excels in getting immediate answers safely without radiation - allowing for screening and repeated monitoring. Such is the case in this test sample.
According to radiologist Dr. Robert Bard, indication of the presence of Covid-19 will show in the form of B-LINES (or the 2 vertical rays). "B-Lines specifically mean that the lung tissue adjacent to the coating of the lung is abnormal- and that's what generates these lines. Normal lung tissue should never have B-lines. If you don't have B-Lines, you don't have Covid in the lungs..."
ULTRASOUND ACCESS TO THE "NEW WORLD" OF MEDICINE
The evolution of the portable ultrasound is now being viewed by many as a diagnostic game-changer for patient care in the field. From an interview with professional technical instructor Michael Thury of Terason Ultrasound, he states "the industry just exploded from 30 years ago with the ability and the confidence that ultrasound can give you. The technology enables the physician to really do a much better job diagnosing the patient. As a clinical trainer with clients worldwide, the boom of telemedicine adds to the success of teaching clinicians how to get the most out of remote ultrasound, but also to have fast and easy access to the physician to read and diagnose the patient from any location!"