tetano
Editor, Senior Moderator
Med Clin (Barc)
. 2021 Jan 28;S0025-7753(21)00015-4.
doi: 10.1016/j.medcli.2020.12.007. Online ahead of print.
Point-of-care ultrasonography in the initial characterization of patients with COVID-19
[Article in English, Spanish]
Yale Tung-Chen[SUP] 1 [/SUP], Ana Algora-Mart?n[SUP] 2 [/SUP], Rafael Llamas-Fuentes[SUP] 3 [/SUP], Pablo Rodr?guez-Fuertes[SUP] 2 [/SUP], Ana Mar?a Mart?nez Virto[SUP] 2 [/SUP], Elena Sanz-Rodr?guez[SUP] 4 [/SUP], Blanca Alonso-Mart?nez[SUP] 5 [/SUP], Maria Ang?lica Rivera N??ez[SUP] 2 [/SUP]
Affiliations
Abstract
Background: There 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.
Objectives: To 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.
Methods: Prospective 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.
Results: Between 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 pO[SUB]2[/SUB] (rho=-0.539; p=.014) and inspiratory pO[SUB]2[/SUB] (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.
Conclusions: POCUS parameters have the potential to impact the diagnosis, management, and prognosis of patients with confirmed or suspected COVID-19.
Keywords: Coronavirus disease 2019 (COVID-19); Coronavirus tipo 2 del S?ndrome respiratorio agudo grave (SARS-CoV-2); Ecocardioscopia; Ecograf?a cl?nica; Enfermedad por coronavirus 2019 (COVID-19); Focused cardiac ultrasonography (FOCUS).; Point-of-care ultrasonography (POCUS); Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
. 2021 Jan 28;S0025-7753(21)00015-4.
doi: 10.1016/j.medcli.2020.12.007. Online ahead of print.
Point-of-care ultrasonography in the initial characterization of patients with COVID-19
[Article in English, Spanish]
Yale Tung-Chen[SUP] 1 [/SUP], Ana Algora-Mart?n[SUP] 2 [/SUP], Rafael Llamas-Fuentes[SUP] 3 [/SUP], Pablo Rodr?guez-Fuertes[SUP] 2 [/SUP], Ana Mar?a Mart?nez Virto[SUP] 2 [/SUP], Elena Sanz-Rodr?guez[SUP] 4 [/SUP], Blanca Alonso-Mart?nez[SUP] 5 [/SUP], Maria Ang?lica Rivera N??ez[SUP] 2 [/SUP]
Affiliations
- PMID: 33593636
- DOI: 10.1016/j.medcli.2020.12.007
Abstract
Background: There 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.
Objectives: To 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.
Methods: Prospective 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.
Results: Between 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 pO[SUB]2[/SUB] (rho=-0.539; p=.014) and inspiratory pO[SUB]2[/SUB] (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.
Conclusions: POCUS parameters have the potential to impact the diagnosis, management, and prognosis of patients with confirmed or suspected COVID-19.
Keywords: Coronavirus disease 2019 (COVID-19); Coronavirus tipo 2 del S?ndrome respiratorio agudo grave (SARS-CoV-2); Ecocardioscopia; Ecograf?a cl?nica; Enfermedad por coronavirus 2019 (COVID-19); Focused cardiac ultrasonography (FOCUS).; Point-of-care ultrasonography (POCUS); Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).