• Medicina clinica · May 2021

    Point-of-care ultrasonography in the initial characterization of patients with COVID-19.

    • Yale Tung-Chen, Ana Algora-Martín, Rafael Llamas-Fuentes, Pablo Rodríguez-Fuertes, Ana María Martínez Virto, Elena Sanz-Rodríguez, Blanca Alonso-Martínez, and Maria Angélica Rivera Núñez.
    • Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain; Department of Medicine, Universidad Alfonso X El Sabio, Madrid, Spain. Electronic address: yale.tung@salud.madrid.org.
    • Med Clin (Barc). 2021 May 21; 156 (10): 477484477-484.

    BackgroundThere is growing evidence regarding the imaging findings of coronavirus disease 2019 (COVID-19) in chest X-rays and computed tomography scans; however, their availability during this pandemic outbreak might be compromised. Currently, the role of point-of-care ultrasonography (POCUS) has yet to be explored.ObjectivesTo describe the POCUS findings of COVID-19 in patients with the disease admitted to the emergency department (ED), correlating them with vital signs, laboratory and radiologic results, therapeutic decisions, and the prognosis.MethodsProspective study performed in the ED of 2 academic hospitals. Patients with highly suspected or confirmed COVID-19 underwent a lung ultrasonography (lung POCUS), focused cardiac ultrasound (FOCUS), and inferior vena cava (IVC) exam.ResultsBetween March and April 2020, 96 patients were enrolled. The mean age was 68.2 years (SD 17.5). The most common findings in the lung POCUS were an irregular pleural line (63.2%), bilateral confluence (55.2%), and isolated B-lines (53.1%), which were associated with a positive RT-PCR (odds ratio 4.327; 95% CI 1.216-15.401; p<.001), and correlated with IL-6 levels (rho=0.622; p=.002). The IVC negatively correlated with levels of expiratory pO2 (rho=-0.539; p=.014) and inspiratory pO2 (rho=-0.527; p=0.017), and expiratory diameter positively correlated with troponin I (rho=0.509; p=.03). After the POCUS exam, almost 20% of the patients had an associated condition that required a change in their treatment or management.ConclusionsPOCUS parameters have the potential to impact the diagnosis, management, and prognosis of patients with confirmed or suspected COVID-19.Copyright © 2021 Elsevier España, S.L.U. All rights reserved.

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