Lung ultrasound combined with d-dimer testing for early detection of pulmonary intravascular coagulopathy in covid-19 pneumonia

The outbreak of the coronavirus disease 2019 (COVID-19) has show a global spreading trend. Early and effective predictors of clinical outcomes are urgently needed to improve management of Covid-19 patients. Lung ultrasound (LUS) combined with D-Dimer (DD) testing could be a new strategy for early diagnosis in patients with suspected COVID-19 pneumonia associated with acute respiratory distress syndrome (ARDS) and helpful prevent the progression of intravascular pulmonary coagulopathy. Modern assay for D-dimer are monoclonal antibody based. The enzyme-linked immunosorbent assay (ELISA) is the reference method for D-dimer analysis. Elevated D-dimer levels are associated with clotting activation and fibrinolysis and can be used as indirect biomarkers of thrombosis than in combination with B-lines detected by lung ultrasound become highly sensitive in the diagnosis of pulmonary intravascular coagulopathy in COVID-19 pneumonia. Careful attention needs to be paid to the initial diagnosis, prevention and treatment of the prothrombotic and thrombotic state that can occur in a substantial percentage of COVID-19 patients. We believe that lung ultrasound early detection in COVID-19 and a rapid D-dimer assay may provide better prognosis in these patients.