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Lung Ultrasound Findings in COVID-19: A Descriptive Retrospective Study

Background Point-of-care ultrasound (POCUS) is an indispensable tool in emergency medicine. With the emergence of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a need for improved diagnostic capabilities and prognostic indica...

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Autores principales: Omer, Talib, Cousins, Collin, Lynch, Taylor, Le, Nhu-Nguyen, Sajed, Dana, Mailhot, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9021013/
https://www.ncbi.nlm.nih.gov/pubmed/35475095
http://dx.doi.org/10.7759/cureus.23375
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author Omer, Talib
Cousins, Collin
Lynch, Taylor
Le, Nhu-Nguyen
Sajed, Dana
Mailhot, Thomas
author_facet Omer, Talib
Cousins, Collin
Lynch, Taylor
Le, Nhu-Nguyen
Sajed, Dana
Mailhot, Thomas
author_sort Omer, Talib
collection PubMed
description Background Point-of-care ultrasound (POCUS) is an indispensable tool in emergency medicine. With the emergence of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a need for improved diagnostic capabilities and prognostic indicators for patients who are symptomatic for COVID-19 has become apparent. POCUS has been demonstrated to be a useful diagnostic and prognostic tool in the emergency department (ED) in assessing other lung complications. Still, limited data regarding its utility in assessing COVID-19 are available. This study sought to evaluate whether POCUS findings in the ED were correlated with vital signs or laboratory abnormalities typically seen among patients with COVID-19. Methods A retrospective study was conducted that included 39 patients who presented with COVID-19 and systemic inflammatory response syndrome (SIRS) to a large, urban tertiary care ED. The study population was limited to adults aged 18 and above who came to the ED with the primary complaint of respiratory symptoms, met SIRS criteria on admission, and had images of at least one anterior and one posterior intercostal space per lung and a minimum of four intercostal spaces. POCUS images were obtained by trained operators in the ED using portable ultrasound machines, recorded in an image database, and reviewed by ultrasound fellowship-trained emergency physicians. Clinical data (e.g., acute phase reactants and vital signs) were obtained through a chart review of patients’ electronic medical records. Results  Both the percentage of intercostal spaces with B-lines and the percentage of merging B-lines were correlated with decreased oxygen saturation on presentation. No other statistically significant correlations were observed between these sonographic findings and other vital signs or acute phase reactants, nor between these clinical data and the percentage of intercostal spaces that were positive for the shred sign. Conclusions With the emergence of the COVID-19 pandemic, emergency medicine physicians are on the frontline of identifying and caring for patients affected by the virus. This study found that sonographic findings associated with interstitial pneumonitis, notably merging B-lines, and the overall percentage of intercostal spaces with B-lines, were clearly associated with worsening oxygen saturation, now thought to be one of the driving causes of morbidity and mortality in COVID-19. As ultrasound has become a ubiquitous and indispensable tool in the ED, this study demonstrated its utility in assessing and managing patients with COVID-19. Bedside ultrasound is a cheap, fast, and non-invasive tool that healthcare providers can use as an essential adjunct in addition to laboratory markers and other imaging modalities for the diagnosis and prognosis of COVID-19.
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spelling pubmed-90210132022-04-25 Lung Ultrasound Findings in COVID-19: A Descriptive Retrospective Study Omer, Talib Cousins, Collin Lynch, Taylor Le, Nhu-Nguyen Sajed, Dana Mailhot, Thomas Cureus Emergency Medicine Background Point-of-care ultrasound (POCUS) is an indispensable tool in emergency medicine. With the emergence of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a need for improved diagnostic capabilities and prognostic indicators for patients who are symptomatic for COVID-19 has become apparent. POCUS has been demonstrated to be a useful diagnostic and prognostic tool in the emergency department (ED) in assessing other lung complications. Still, limited data regarding its utility in assessing COVID-19 are available. This study sought to evaluate whether POCUS findings in the ED were correlated with vital signs or laboratory abnormalities typically seen among patients with COVID-19. Methods A retrospective study was conducted that included 39 patients who presented with COVID-19 and systemic inflammatory response syndrome (SIRS) to a large, urban tertiary care ED. The study population was limited to adults aged 18 and above who came to the ED with the primary complaint of respiratory symptoms, met SIRS criteria on admission, and had images of at least one anterior and one posterior intercostal space per lung and a minimum of four intercostal spaces. POCUS images were obtained by trained operators in the ED using portable ultrasound machines, recorded in an image database, and reviewed by ultrasound fellowship-trained emergency physicians. Clinical data (e.g., acute phase reactants and vital signs) were obtained through a chart review of patients’ electronic medical records. Results  Both the percentage of intercostal spaces with B-lines and the percentage of merging B-lines were correlated with decreased oxygen saturation on presentation. No other statistically significant correlations were observed between these sonographic findings and other vital signs or acute phase reactants, nor between these clinical data and the percentage of intercostal spaces that were positive for the shred sign. Conclusions With the emergence of the COVID-19 pandemic, emergency medicine physicians are on the frontline of identifying and caring for patients affected by the virus. This study found that sonographic findings associated with interstitial pneumonitis, notably merging B-lines, and the overall percentage of intercostal spaces with B-lines, were clearly associated with worsening oxygen saturation, now thought to be one of the driving causes of morbidity and mortality in COVID-19. As ultrasound has become a ubiquitous and indispensable tool in the ED, this study demonstrated its utility in assessing and managing patients with COVID-19. Bedside ultrasound is a cheap, fast, and non-invasive tool that healthcare providers can use as an essential adjunct in addition to laboratory markers and other imaging modalities for the diagnosis and prognosis of COVID-19. Cureus 2022-03-21 /pmc/articles/PMC9021013/ /pubmed/35475095 http://dx.doi.org/10.7759/cureus.23375 Text en Copyright © 2022, Omer et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Omer, Talib
Cousins, Collin
Lynch, Taylor
Le, Nhu-Nguyen
Sajed, Dana
Mailhot, Thomas
Lung Ultrasound Findings in COVID-19: A Descriptive Retrospective Study
title Lung Ultrasound Findings in COVID-19: A Descriptive Retrospective Study
title_full Lung Ultrasound Findings in COVID-19: A Descriptive Retrospective Study
title_fullStr Lung Ultrasound Findings in COVID-19: A Descriptive Retrospective Study
title_full_unstemmed Lung Ultrasound Findings in COVID-19: A Descriptive Retrospective Study
title_short Lung Ultrasound Findings in COVID-19: A Descriptive Retrospective Study
title_sort lung ultrasound findings in covid-19: a descriptive retrospective study
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9021013/
https://www.ncbi.nlm.nih.gov/pubmed/35475095
http://dx.doi.org/10.7759/cureus.23375
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