Ultrasound in medicine & biology
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Ultrasound Med Biol · Nov 2020
Lung Ultrasound Score in Evaluating the Severity of Coronavirus Disease 2019 (COVID-19) Pneumonia.
The purpose of this study is to observe the potential of lung ultrasound in evaluating the severity of coronavirus disease 2019 (COVID-19) pneumonia. Lung ultrasound was performed in ten zones of the patients' chest walls. The features of the ultrasound images were observed, and a lung ultrasound score (LUS) was recorded. ⋯ The LUS was significantly higher in the refractory group (33.00 [IQR 27.50-34.00] vs. 25.50 [IQR 22.75-30.00]). The ROC of the LUS showed a cutoff score of 32 with a specificity of 0.893 and a sensitivity of 0.571 in diagnosing refractory respiratory failure among patients. In COVID-19 patients, lung ultrasound is a promising diagnostic tool in diagnosing patients with refractory pneumonia.
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Ultrasound Med Biol · Nov 2020
Lung Ultrasound Findings Are Associated with Mortality and Need for Intensive Care Admission in COVID-19 Patients Evaluated in the Emergency Department.
Lung ultrasound (LUS) has recently been advocated as an accurate tool to diagnose coronavirus disease 2019 (COVID-19) pneumonia. However, reports on its use are based mainly on hypothesis studies, case reports or small retrospective case series, while the prognostic role of LUS in COVID-19 patients has not yet been established. We conducted a prospective study aimed at assessing the ability of LUS to predict mortality and intensive care unit admission of COVID-19 patients evaluated in a tertiary level emergency department. ⋯ A higher rate of pathologic lung areas and a higher average score were significantly associated with death, with an estimated difference of 40.5% (95% confidence interval [CI]: 4%-68%, p = 0.01) and of 0.47 (95% CI: 0.06-0.93, p = 0.02), respectively. Similarly, the same parameters were associated with a significantly higher risk of intensive care unit admission with estimated differences of 29% (95% CI: 8%-50%, p = 0.008) and 0.47 (95% CI: 0.05-0.93, p = 0.02), respectively. Our study indicates that LUS is able to detect COVID-19 pneumonia and to predict, during the first evaluation in the emergency department, patients at risk for intensive care unit admission and death.
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Ultrasound Med Biol · Oct 2020
Use of Lung Ultrasound to Differentiate Coronavirus Disease 2019 (COVID-19) Pneumonia From Community-Acquired Pneumonia.
To investigate the feasibility of lung ultrasound in evaluating coronavirus disease 2019 (COVID-19) and distinguish the sonographic features between COVID-19 and community-acquired pneumonia (CAP), a total of 12 COVID-19 patients and 20 CAP patients were selected and underwent lung ultrasound. The modified Buda scoring system for interstitial lung disease was used to evaluate the severity and treatment effect of COVID-19 on ultrasonography. The differences between modified lung ultrasound (MLUS) score and high-resolution computed tomography (HRCT) Warrick score were analyzed to evaluate their correlation. ⋯ MLUS scores (Z = 2.61, p = 0.009) and HRCT Warrick scores (Z = 2.63, p = 0.009) of five severe or critical COVID-19 patients significantly decreased as their conditions improved after treatment. The differences of sonographic features between COVID-19 and CAP patients were notable. The MLUS scoring system could be used to evaluate the severity and treatment effect of COVID-19.
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Ultrasound Med Biol · Sep 2020
ReviewA Review of Early Experience in Lung Ultrasound in the Diagnosis and Management of COVID-19.
A novel coronavirus (2019-nCoV) was identified as the cause of a cluster of pneumonia in Wuhan, China, at the end of 2019. Since then more than eight million confirmed cases of coronavirus disease 2019 (COVID-19) have been reported around the globe. The current gold standard for etiologic diagnosis is reverse transcription-polymerase chain reaction analysis of respiratory-tract specimens, but the test has a high false-negative rate owing to both nasopharyngeal swab sampling error and viral burden. ⋯ Although the number of studies to date is limited, LUS findings have demonstrated high diagnostic sensitivity and accuracy, comparable with those of chest computed tomography scans. In this note we review the current state of the art of LUS in evaluating pulmonary changes induced by COVID-19. The goal is to identify characteristic sonographic findings most suited for the diagnosis of COVID-19 pneumonia infections.
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Ultrasound Med Biol · Aug 2020
Lung Ultrasound in Patients with Acute Respiratory Failure Reduces Conventional Imaging and Health Care Provider Exposure to COVID-19.
Lung ultrasound gained a leading position in the last year as an imaging technique for the assessment and management of patients with acute respiratory failure. In coronavirus disease 2019 (COVID-19), its role may be of further importance because it is performed bedside and may limit chest X-ray and the need for transport to radiology for computed tomography (CT) scan. Since February 21, we progressively turned into a coronavirus-dedicated intensive care unit and applied an ultrasound-based approach to avoid traditional imaging and limit contamination as much as possible. ⋯ We compared conventional imaging exams performed in the first 4 wk of the COVID-19 epidemic with those in the same time frame in 2019: there were 84 patients in 2020 and 112 in 2019; 64 and 22 (76.2% vs. 19.6%, p < 0.001) had acute respiratory failure, respectively, of which 55 (85.9%) were COVID-19 in 2020. When COVID-19 patients in 2020 were compared with acute respiratory failure patients in 2019, the median number of chest X-rays was 1.0 (1.0-2.0) versus 3.0 (1.0-4.0) (p = 0.0098); 2 patients 2 (3.6%) versus 7 patients (31.8%) had undergone at least one thoracic CT scan (p = 0.001). A self-imposed ultrasound-based approach reduces the number of chest X-rays and thoracic CT scans in COVID-19 patients compared with patients with standard acute respiratory failure, thus reducing the number of health care providers exposed to possible contamination and sparing personal protective equipment.