tetano
Editor, Senior Moderator
J Clin Med
. 2020 Sep 16;9(9):E2990.
doi: 10.3390/jcm9092990.
Clinical Features and Chest Imaging as Predictors of Intensity of Care in Patients with COVID-19
Elisabetta Cocconcelli[SUP] 1 [/SUP], Davide Biondini[SUP] 1 [/SUP], Chiara Giraudo[SUP] 2 [/SUP], Sara Lococo[SUP] 1 [/SUP], Nicol Bernardinello[SUP] 1 [/SUP], Giulia Fichera[SUP] 2 [/SUP], Giulio Barbiero[SUP] 2 [/SUP], Gioele Castelli[SUP] 3 [/SUP], Silvia Cavinato[SUP] 4 [/SUP], Anna Ferrari[SUP] 4 [/SUP], Marina Saetta[SUP] 1 [/SUP], Annamaria Cattelan[SUP] 4 [/SUP], Paolo Spagnolo[SUP] 1 [/SUP], Elisabetta Balestro[SUP] 1 [/SUP]
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic with lung disease representing the main cause of morbidity and mortality. Conventional chest-X ray (CXR) and ultrasound (US) are valuable instruments to assess the extent of lung involvement. We investigated the relationship between CXR scores on admission and the level of medical care required in patients with COVID-19. Further, we assessed the CXR-US correlation to explore the role of ultrasound in monitoring the course of COVID-19 pneumonia. Clinical features and CXR scores were obtained at admission and correlated with the level of intensity of care required [high- (HIMC) versus low-intensity medical care (LIMC)]. In a subgroup of patients, US findings were correlated with clinical and radiographic parameters. On hospital admission, CXR global score was higher in HIMCs compared to LIMC. Smoking history, pO[SUB]2[/SUB] on admission, cardiovascular and oncologic diseases were independent predictors of HIMC. The US score was positively correlated with FiO[SUB]2[/SUB] while the correlation with CXR global score only trended towards significance. Our study identifies clinical and radiographic features that strongly correlate with higher levels of medical care. The role of lung ultrasound in this setting remains undetermined and needs to be explored in larger prospective studies.
Keywords: COVID-19; chest X-ray; outcome of severity; ultrasound.
. 2020 Sep 16;9(9):E2990.
doi: 10.3390/jcm9092990.
Clinical Features and Chest Imaging as Predictors of Intensity of Care in Patients with COVID-19
Elisabetta Cocconcelli[SUP] 1 [/SUP], Davide Biondini[SUP] 1 [/SUP], Chiara Giraudo[SUP] 2 [/SUP], Sara Lococo[SUP] 1 [/SUP], Nicol Bernardinello[SUP] 1 [/SUP], Giulia Fichera[SUP] 2 [/SUP], Giulio Barbiero[SUP] 2 [/SUP], Gioele Castelli[SUP] 3 [/SUP], Silvia Cavinato[SUP] 4 [/SUP], Anna Ferrari[SUP] 4 [/SUP], Marina Saetta[SUP] 1 [/SUP], Annamaria Cattelan[SUP] 4 [/SUP], Paolo Spagnolo[SUP] 1 [/SUP], Elisabetta Balestro[SUP] 1 [/SUP]
Affiliations
- PMID: 32947904
- DOI: 10.3390/jcm9092990
Abstract
Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic with lung disease representing the main cause of morbidity and mortality. Conventional chest-X ray (CXR) and ultrasound (US) are valuable instruments to assess the extent of lung involvement. We investigated the relationship between CXR scores on admission and the level of medical care required in patients with COVID-19. Further, we assessed the CXR-US correlation to explore the role of ultrasound in monitoring the course of COVID-19 pneumonia. Clinical features and CXR scores were obtained at admission and correlated with the level of intensity of care required [high- (HIMC) versus low-intensity medical care (LIMC)]. In a subgroup of patients, US findings were correlated with clinical and radiographic parameters. On hospital admission, CXR global score was higher in HIMCs compared to LIMC. Smoking history, pO[SUB]2[/SUB] on admission, cardiovascular and oncologic diseases were independent predictors of HIMC. The US score was positively correlated with FiO[SUB]2[/SUB] while the correlation with CXR global score only trended towards significance. Our study identifies clinical and radiographic features that strongly correlate with higher levels of medical care. The role of lung ultrasound in this setting remains undetermined and needs to be explored in larger prospective studies.
Keywords: COVID-19; chest X-ray; outcome of severity; ultrasound.