tetano
Editor, Senior Moderator
Ultrasound Med Biol
. 2020 Jul 24;S0301-5629(20)30339-2.
doi: 10.1016/j.ultrasmedbio.2020.07.024. Online ahead of print.
Lung Ultrasound Score in Evaluating the Severity of Coronavirus Disease 2019 (COVID-19) Pneumonia
Lina Zhao[SUP] 1 [/SUP], Kanglong Yu[SUP] 1 [/SUP], Qi Zhao[SUP] 1 [/SUP], Rui Tian[SUP] 1 [/SUP], Hui Xie[SUP] 1 [/SUP], Lijun Xie[SUP] 1 [/SUP], Puyu Deng[SUP] 1 [/SUP], Guogang Xie[SUP] 2 [/SUP], Aihua Bao[SUP] 2 [/SUP], Jiang Du[SUP] 3 [/SUP]
Affiliations
Abstract
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 ultrasound features and scores were compared between the refractory group (PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] ≤ 100 mm Hg or on extracorporeal membrane oxygenation) and the non-refractory group. The prediction value of the LUS was studied by receiver operating characteristic (ROC) curve analysis. In total, 7 patients were enrolled in the refractory group and 28 in the non-refractory group. B-line patterns and shred signs were the most common signs in all patients. Patients in the refractory group had significantly more ground-glass signs (median 6 [interquartile range {IQR}, 2.5-6.5] vs. median 0 [IQR, 0-3]), consolidation signs (median 1 [IQR, 1-1.5] vs. median 0 [IQR, 0-3]) and pleural effusions (median 5 [IQR, 1.5-6] vs. median 0 [IQR, 0-0.25]). 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.
Keywords: ARDS; COVID-19; ECMO; Lung ultrasound; Pneumonia.
. 2020 Jul 24;S0301-5629(20)30339-2.
doi: 10.1016/j.ultrasmedbio.2020.07.024. Online ahead of print.
Lung Ultrasound Score in Evaluating the Severity of Coronavirus Disease 2019 (COVID-19) Pneumonia
Lina Zhao[SUP] 1 [/SUP], Kanglong Yu[SUP] 1 [/SUP], Qi Zhao[SUP] 1 [/SUP], Rui Tian[SUP] 1 [/SUP], Hui Xie[SUP] 1 [/SUP], Lijun Xie[SUP] 1 [/SUP], Puyu Deng[SUP] 1 [/SUP], Guogang Xie[SUP] 2 [/SUP], Aihua Bao[SUP] 2 [/SUP], Jiang Du[SUP] 3 [/SUP]
Affiliations
- PMID: 32828577
- DOI: 10.1016/j.ultrasmedbio.2020.07.024
Abstract
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 ultrasound features and scores were compared between the refractory group (PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] ≤ 100 mm Hg or on extracorporeal membrane oxygenation) and the non-refractory group. The prediction value of the LUS was studied by receiver operating characteristic (ROC) curve analysis. In total, 7 patients were enrolled in the refractory group and 28 in the non-refractory group. B-line patterns and shred signs were the most common signs in all patients. Patients in the refractory group had significantly more ground-glass signs (median 6 [interquartile range {IQR}, 2.5-6.5] vs. median 0 [IQR, 0-3]), consolidation signs (median 1 [IQR, 1-1.5] vs. median 0 [IQR, 0-3]) and pleural effusions (median 5 [IQR, 1.5-6] vs. median 0 [IQR, 0-0.25]). 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.
Keywords: ARDS; COVID-19; ECMO; Lung ultrasound; Pneumonia.