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Rapid prognostic stratification using Point of Care ultrasound in critically ill COVID patients: The role of epicardial fat thickness, myocardial injury and age

PURPOSE: The burden of critical COVID-19 patients in intensive care units (ICU) demands new tools to stratify patient risk. We aimed to investigate the role of cardiac and lung ultrasound, together with clinical variables, to propose a simple score to help predict short-term mortality in these patie...

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Autores principales: Millman, Michael, Santos, Angela B.S., Pianca, Eduardo G., Pellegrini, José Augusto Santos, Conci, Fernanda Carine, Foppa, Murilo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8500966/
https://www.ncbi.nlm.nih.gov/pubmed/34638055
http://dx.doi.org/10.1016/j.jcrc.2021.09.013
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author Millman, Michael
Santos, Angela B.S.
Pianca, Eduardo G.
Pellegrini, José Augusto Santos
Conci, Fernanda Carine
Foppa, Murilo
author_facet Millman, Michael
Santos, Angela B.S.
Pianca, Eduardo G.
Pellegrini, José Augusto Santos
Conci, Fernanda Carine
Foppa, Murilo
author_sort Millman, Michael
collection PubMed
description PURPOSE: The burden of critical COVID-19 patients in intensive care units (ICU) demands new tools to stratify patient risk. We aimed to investigate the role of cardiac and lung ultrasound, together with clinical variables, to propose a simple score to help predict short-term mortality in these patients. MATERIAL AND METHODS: We collected clinical and laboratorial data, and a point-of-care cardiac and lung ultrasound was performed in the first 36 h of admission in the ICU. RESULTS: Out of 78 patients (61 ± 12y-o, 55% male), 33 (42%) died during the hospitalization. Deceased patients were generally older, had worse values for SOFA score, baseline troponin levels, left ventricular ejection fraction (LVEF), LV diastolic function, and increased epicardial fat thickness (EFT), despite a similar prevalence of severe lung ultrasound scores. Based on the multivariable model, we created the POCOVID score, including age (>60 years), myocardial injury (LVEF<50% and/or usTnI>99til), and increased EFT (>0.8 cm). The presence of two out of these three criteria identified patients with almost twice the risk of death. CONCLUSIONS: A higher POCOVID score at ICU admission can be helpful to stratify critical COVID-19 patients with increased in-hospital mortality and to optimize medical resources allocation in more strict-resource settings.
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spelling pubmed-85009662021-10-12 Rapid prognostic stratification using Point of Care ultrasound in critically ill COVID patients: The role of epicardial fat thickness, myocardial injury and age Millman, Michael Santos, Angela B.S. Pianca, Eduardo G. Pellegrini, José Augusto Santos Conci, Fernanda Carine Foppa, Murilo J Crit Care Article PURPOSE: The burden of critical COVID-19 patients in intensive care units (ICU) demands new tools to stratify patient risk. We aimed to investigate the role of cardiac and lung ultrasound, together with clinical variables, to propose a simple score to help predict short-term mortality in these patients. MATERIAL AND METHODS: We collected clinical and laboratorial data, and a point-of-care cardiac and lung ultrasound was performed in the first 36 h of admission in the ICU. RESULTS: Out of 78 patients (61 ± 12y-o, 55% male), 33 (42%) died during the hospitalization. Deceased patients were generally older, had worse values for SOFA score, baseline troponin levels, left ventricular ejection fraction (LVEF), LV diastolic function, and increased epicardial fat thickness (EFT), despite a similar prevalence of severe lung ultrasound scores. Based on the multivariable model, we created the POCOVID score, including age (>60 years), myocardial injury (LVEF<50% and/or usTnI>99til), and increased EFT (>0.8 cm). The presence of two out of these three criteria identified patients with almost twice the risk of death. CONCLUSIONS: A higher POCOVID score at ICU admission can be helpful to stratify critical COVID-19 patients with increased in-hospital mortality and to optimize medical resources allocation in more strict-resource settings. Elsevier Inc. 2022-02 2021-10-09 /pmc/articles/PMC8500966/ /pubmed/34638055 http://dx.doi.org/10.1016/j.jcrc.2021.09.013 Text en © 2021 Elsevier Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Millman, Michael
Santos, Angela B.S.
Pianca, Eduardo G.
Pellegrini, José Augusto Santos
Conci, Fernanda Carine
Foppa, Murilo
Rapid prognostic stratification using Point of Care ultrasound in critically ill COVID patients: The role of epicardial fat thickness, myocardial injury and age
title Rapid prognostic stratification using Point of Care ultrasound in critically ill COVID patients: The role of epicardial fat thickness, myocardial injury and age
title_full Rapid prognostic stratification using Point of Care ultrasound in critically ill COVID patients: The role of epicardial fat thickness, myocardial injury and age
title_fullStr Rapid prognostic stratification using Point of Care ultrasound in critically ill COVID patients: The role of epicardial fat thickness, myocardial injury and age
title_full_unstemmed Rapid prognostic stratification using Point of Care ultrasound in critically ill COVID patients: The role of epicardial fat thickness, myocardial injury and age
title_short Rapid prognostic stratification using Point of Care ultrasound in critically ill COVID patients: The role of epicardial fat thickness, myocardial injury and age
title_sort rapid prognostic stratification using point of care ultrasound in critically ill covid patients: the role of epicardial fat thickness, myocardial injury and age
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8500966/
https://www.ncbi.nlm.nih.gov/pubmed/34638055
http://dx.doi.org/10.1016/j.jcrc.2021.09.013
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