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Lung ultrasound and computed tomography to monitor COVID-19 pneumonia in critically ill patients: a two-center prospective cohort study

BACKGROUND: Lung ultrasound can adequately monitor disease severity in pneumonia and acute respiratory distress syndrome. We hypothesize lung ultrasound can adequately monitor COVID-19 pneumonia in critically ill patients. METHODS: Adult patients with COVID-19 pneumonia admitted to the intensive car...

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Autores principales: Heldeweg, Micah L. A., Lopez Matta, Jorge E., Haaksma, Mark E., Smit, Jasper M., Elzo Kraemer, Carlos V., de Grooth, Harm-Jan, de Jonge, Evert, Meijboom, Lilian J., Heunks, Leo M. A., van Westerloo, David J., Tuinman, Pieter R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7829056/
https://www.ncbi.nlm.nih.gov/pubmed/33491147
http://dx.doi.org/10.1186/s40635-020-00367-3
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author Heldeweg, Micah L. A.
Lopez Matta, Jorge E.
Haaksma, Mark E.
Smit, Jasper M.
Elzo Kraemer, Carlos V.
de Grooth, Harm-Jan
de Jonge, Evert
Meijboom, Lilian J.
Heunks, Leo M. A.
van Westerloo, David J.
Tuinman, Pieter R.
author_facet Heldeweg, Micah L. A.
Lopez Matta, Jorge E.
Haaksma, Mark E.
Smit, Jasper M.
Elzo Kraemer, Carlos V.
de Grooth, Harm-Jan
de Jonge, Evert
Meijboom, Lilian J.
Heunks, Leo M. A.
van Westerloo, David J.
Tuinman, Pieter R.
author_sort Heldeweg, Micah L. A.
collection PubMed
description BACKGROUND: Lung ultrasound can adequately monitor disease severity in pneumonia and acute respiratory distress syndrome. We hypothesize lung ultrasound can adequately monitor COVID-19 pneumonia in critically ill patients. METHODS: Adult patients with COVID-19 pneumonia admitted to the intensive care unit of two academic hospitals who underwent a 12-zone lung ultrasound and a chest CT examination were included. Baseline characteristics, and outcomes including composite endpoint death or ICU stay > 30 days were recorded. Lung ultrasound and CT images were quantified as a lung ultrasound score involvement index (LUSI) and CT severity involvement index (CTSI). Primary outcome was the correlation, agreement, and concordance between LUSI and CTSI. Secondary outcome was the association of LUSI and CTSI with the composite endpoints. RESULTS: We included 55 ultrasound examinations in 34 patients, which were 88% were male, with a mean age of 63 years and mean P/F ratio of 151. The correlation between LUSI and CTSI was strong (r = 0.795), with an overall 15% bias, and limits of agreement ranging − 40 to 9.7. Concordance between changes in sequentially measured LUSI and CTSI was 81%. In the univariate model, high involvement on LUSI and CTSI were associated with a composite endpoint. In the multivariate model, LUSI was the only remaining independent predictor. CONCLUSIONS: Lung ultrasound can be used as an alternative for chest CT in monitoring COVID-19 pneumonia in critically ill patients as it can quantify pulmonary involvement, register changes over the course of the disease, and predict death or ICU stay > 30 days. Trial registration: NTR, NL8584. Registered 01 May 2020—retrospectively registered, https://www.trialregister.nl/trial/8584
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spelling pubmed-78290562021-01-25 Lung ultrasound and computed tomography to monitor COVID-19 pneumonia in critically ill patients: a two-center prospective cohort study Heldeweg, Micah L. A. Lopez Matta, Jorge E. Haaksma, Mark E. Smit, Jasper M. Elzo Kraemer, Carlos V. de Grooth, Harm-Jan de Jonge, Evert Meijboom, Lilian J. Heunks, Leo M. A. van Westerloo, David J. Tuinman, Pieter R. Intensive Care Med Exp Research Articles BACKGROUND: Lung ultrasound can adequately monitor disease severity in pneumonia and acute respiratory distress syndrome. We hypothesize lung ultrasound can adequately monitor COVID-19 pneumonia in critically ill patients. METHODS: Adult patients with COVID-19 pneumonia admitted to the intensive care unit of two academic hospitals who underwent a 12-zone lung ultrasound and a chest CT examination were included. Baseline characteristics, and outcomes including composite endpoint death or ICU stay > 30 days were recorded. Lung ultrasound and CT images were quantified as a lung ultrasound score involvement index (LUSI) and CT severity involvement index (CTSI). Primary outcome was the correlation, agreement, and concordance between LUSI and CTSI. Secondary outcome was the association of LUSI and CTSI with the composite endpoints. RESULTS: We included 55 ultrasound examinations in 34 patients, which were 88% were male, with a mean age of 63 years and mean P/F ratio of 151. The correlation between LUSI and CTSI was strong (r = 0.795), with an overall 15% bias, and limits of agreement ranging − 40 to 9.7. Concordance between changes in sequentially measured LUSI and CTSI was 81%. In the univariate model, high involvement on LUSI and CTSI were associated with a composite endpoint. In the multivariate model, LUSI was the only remaining independent predictor. CONCLUSIONS: Lung ultrasound can be used as an alternative for chest CT in monitoring COVID-19 pneumonia in critically ill patients as it can quantify pulmonary involvement, register changes over the course of the disease, and predict death or ICU stay > 30 days. Trial registration: NTR, NL8584. Registered 01 May 2020—retrospectively registered, https://www.trialregister.nl/trial/8584 Springer International Publishing 2021-01-25 /pmc/articles/PMC7829056/ /pubmed/33491147 http://dx.doi.org/10.1186/s40635-020-00367-3 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Research Articles
Heldeweg, Micah L. A.
Lopez Matta, Jorge E.
Haaksma, Mark E.
Smit, Jasper M.
Elzo Kraemer, Carlos V.
de Grooth, Harm-Jan
de Jonge, Evert
Meijboom, Lilian J.
Heunks, Leo M. A.
van Westerloo, David J.
Tuinman, Pieter R.
Lung ultrasound and computed tomography to monitor COVID-19 pneumonia in critically ill patients: a two-center prospective cohort study
title Lung ultrasound and computed tomography to monitor COVID-19 pneumonia in critically ill patients: a two-center prospective cohort study
title_full Lung ultrasound and computed tomography to monitor COVID-19 pneumonia in critically ill patients: a two-center prospective cohort study
title_fullStr Lung ultrasound and computed tomography to monitor COVID-19 pneumonia in critically ill patients: a two-center prospective cohort study
title_full_unstemmed Lung ultrasound and computed tomography to monitor COVID-19 pneumonia in critically ill patients: a two-center prospective cohort study
title_short Lung ultrasound and computed tomography to monitor COVID-19 pneumonia in critically ill patients: a two-center prospective cohort study
title_sort lung ultrasound and computed tomography to monitor covid-19 pneumonia in critically ill patients: a two-center prospective cohort study
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7829056/
https://www.ncbi.nlm.nih.gov/pubmed/33491147
http://dx.doi.org/10.1186/s40635-020-00367-3
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