• Di Coneybeare, Devjani Das, Penelope Lema, Bernard Chang, and Lorraine Ng.
• Department of Emergency Medicine, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, New York.
• J Emerg Med. 2021 Jul 1; 61 (1): 616661-66.

BackgroundPatients with coronavirus disease 2019 (COVID-19) present with diagnostic challenges because COVID-19 can cause varied end-organ failures that mimic respiratory distress of pulmonary origin. Early identification of concurrent complications can significantly alter patient management and course. Point-of-care ultrasound (POCUS) can be particularly useful in helping to differentiate concomitant complications with COVID-19. While lung POCUS findings related to COVID-19 have been published, little guidance exists on how ultrasound can be incorporated into a more comprehensive evaluation of patients under investigation for COVID-19.ObjectivesWe devised a pathway called COVUS that incorporates POCUS into the initial evaluation of patients under investigation for COVID-19 to guide diagnosis and management.DiscussionThe pathway was derived based on a review of literature, consensus from the ultrasound faculty, as well as feedback from the entire faculty group at one academic institution with high volumes of patients with COVID-19. The scanning protocol uses a cardiac-first (rather than lung-first) approach to identify potential concomitant organ failure that may immediately alter management.ConclusionsCOVUS aims to maximize identification of the most immediately life-threatening complications while minimizing time at bedside and provider risk of exposure to COVID-19.Copyright © 2021 Elsevier Inc. All rights reserved.

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