tetano
Editor, Senior Moderator
J Ultrasound Med
. 2020 Nov 6.
doi: 10.1002/jum.15548. Online ahead of print.
A New Lung Ultrasound Protocol Able to Predict Worsening in Patients Affected by Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia
Tiziano Perrone[SUP] 1 [/SUP], Gino Soldati[SUP] 2 [/SUP], Lucia Padovini[SUP] 1 [/SUP], Anna Fiengo[SUP] 1 [/SUP], Gianluca Lettieri[SUP] 1 [/SUP], Umberto Sabatini[SUP] 1 [/SUP], Giulia Gori[SUP] 1 [/SUP], Federica Lepore[SUP] 1 [/SUP], Matteo Garolfi[SUP] 1 [/SUP], Ilaria Palumbo[SUP] 1 [/SUP], Riccardo Inchingolo[SUP] 3 [/SUP], Andrea Smargiassi[SUP] 3 [/SUP], Libertario Demi[SUP] 4 [/SUP], Elisa Eleonora Mossolani[SUP] 5 [/SUP], Francesco Tursi[SUP] 6 [/SUP], Catherine Klersy[SUP] 7 [/SUP], Antonio Di Sabatino[SUP] 1 [/SUP]
Affiliations
Abstract
Objectives: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can generate severe pneumonia associated with high mortality. A bedside lung ultrasound (LUS) examination has been shown to have a potential role in this setting. The purpose of this study was to evaluate the potential prognostic value of a new LUS protocol (evaluation of 14 anatomic landmarks, with graded scores of 0-3) in patients with SARS-CoV-2 pneumonia and the association of LUS patterns with clinical or laboratory findings.
Methods: A cohort of 52 consecutive patients with laboratory-confirmed SARS-CoV-2 underwent LUS examinations on admission in an internal medicine ward and before their discharge. A total LUS score as the sum of the scores at each explored area was computed. We investigated the association between the LUS score and clinical worsening, defined as a combination of high-flow oxygen support, intensive care unit admission, or 30-day mortality as the primary end point.
Results: Twenty (39%) patients showed a worse outcome during the observation period; the mean LUS scores ? SDs were 20.4 ? 8.5 and 29.2 ? 7.3 in patients without and with worsening, respectively (P < .001). In a multivariable analysis, adjusted for comorbidities (>2), age (>65 years), sex (male), and body mass index (≥25 kg/m[SUP]2[/SUP] ), the association between the LUS score and worsening (odds ratio, 1.17; 95% confidence interval, 1.05 to 1.29; P = .003) was confirmed, with good discrimination of the model (area under the receiver operating characteristic curve, 0.82). A median LUS score higher than 24 was associated with an almost 6-fold increase in the odds of worsening (odds ratio, 5.67; 95% confidence interval, 1.29 to 24.8; P = .021).
Conclusions: Lung ultrasound can represent an effective tool for monitoring and stratifying the prognosis of patients with SARS-CoV-2 pulmonary involvement.
Keywords: B-line; consolidations; lung ultrasound; severe acute respiratory syndrome coronavirus 2 pneumonia; vertical artifacts.
. 2020 Nov 6.
doi: 10.1002/jum.15548. Online ahead of print.
A New Lung Ultrasound Protocol Able to Predict Worsening in Patients Affected by Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia
Tiziano Perrone[SUP] 1 [/SUP], Gino Soldati[SUP] 2 [/SUP], Lucia Padovini[SUP] 1 [/SUP], Anna Fiengo[SUP] 1 [/SUP], Gianluca Lettieri[SUP] 1 [/SUP], Umberto Sabatini[SUP] 1 [/SUP], Giulia Gori[SUP] 1 [/SUP], Federica Lepore[SUP] 1 [/SUP], Matteo Garolfi[SUP] 1 [/SUP], Ilaria Palumbo[SUP] 1 [/SUP], Riccardo Inchingolo[SUP] 3 [/SUP], Andrea Smargiassi[SUP] 3 [/SUP], Libertario Demi[SUP] 4 [/SUP], Elisa Eleonora Mossolani[SUP] 5 [/SUP], Francesco Tursi[SUP] 6 [/SUP], Catherine Klersy[SUP] 7 [/SUP], Antonio Di Sabatino[SUP] 1 [/SUP]
Affiliations
- PMID: 33155689
- DOI: 10.1002/jum.15548
Abstract
Objectives: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can generate severe pneumonia associated with high mortality. A bedside lung ultrasound (LUS) examination has been shown to have a potential role in this setting. The purpose of this study was to evaluate the potential prognostic value of a new LUS protocol (evaluation of 14 anatomic landmarks, with graded scores of 0-3) in patients with SARS-CoV-2 pneumonia and the association of LUS patterns with clinical or laboratory findings.
Methods: A cohort of 52 consecutive patients with laboratory-confirmed SARS-CoV-2 underwent LUS examinations on admission in an internal medicine ward and before their discharge. A total LUS score as the sum of the scores at each explored area was computed. We investigated the association between the LUS score and clinical worsening, defined as a combination of high-flow oxygen support, intensive care unit admission, or 30-day mortality as the primary end point.
Results: Twenty (39%) patients showed a worse outcome during the observation period; the mean LUS scores ? SDs were 20.4 ? 8.5 and 29.2 ? 7.3 in patients without and with worsening, respectively (P < .001). In a multivariable analysis, adjusted for comorbidities (>2), age (>65 years), sex (male), and body mass index (≥25 kg/m[SUP]2[/SUP] ), the association between the LUS score and worsening (odds ratio, 1.17; 95% confidence interval, 1.05 to 1.29; P = .003) was confirmed, with good discrimination of the model (area under the receiver operating characteristic curve, 0.82). A median LUS score higher than 24 was associated with an almost 6-fold increase in the odds of worsening (odds ratio, 5.67; 95% confidence interval, 1.29 to 24.8; P = .021).
Conclusions: Lung ultrasound can represent an effective tool for monitoring and stratifying the prognosis of patients with SARS-CoV-2 pulmonary involvement.
Keywords: B-line; consolidations; lung ultrasound; severe acute respiratory syndrome coronavirus 2 pneumonia; vertical artifacts.