No abstract

Bedside lung ultrasound (LUS) can play a role in the setting of the SarsCoV2 pneumonia pandemic. To evaluate the clinical and LUS features of COVID-19 in the ED and their potential prognostic role, a cohort of laboratory-confirmed COVID-19 patients underwent LUS upon admission in the ED. LUS score was derived from 12 fields. A prevalent LUS pattern was assigned depending on the presence of interstitial syndrome only (Interstitial Pattern), or evidence of subpleural consolidations in at least two fields (Consolidation Pattern). The endpoint was 30-day mortality. The relationship between hemogasanalysis parameters and LUS score was also evaluated. Out of 312 patients, only 36 (11.5%) did not present lung involvment, as defined by LUS score < 1. The majority of patients were admitted either in a general ward (53.8%) or in intensive care unit (9.6%), whereas 106 patients (33.9%) were discharged from the ED. In-hospital mortality was 25.3%, and 30-day survival was 67.6%. A LUS score > 13 had a 77.2% sensitivity and a 71.5% specificity (AUC 0.814; p < 0.001) in predicting mortality. LUS alterations were more frequent (64%) in the posterior lower fields. LUS score was related with P/F (R2 0.68; p < 0.0001) and P/F at FiO2 = 21% (R2 0.59; p < 0.0001). The correlation between LUS score and P/F was not influenced by the prevalent ultrasound pattern. LUS represents an effective tool in both defining diagnosis and stratifying prognosis of COVID-19 pneumonia. The correlation between LUS and hemogasanalysis parameters underscores its role in evaluating lung structure and function.

Coronavirus disease 2019 (Covid-19), caused by a novel enveloped RNA betacoronavirus, has recently been declared a public health emergency by the World Health Organization (WHO). The lack of knowledge at the beginning of the pandemics, associated with the inherent risk of infective spreading, makes initial recognition and management particularly complex, in terms of defining effective diagnostic and therapeutic protocols. In the Emergency setting, Lung Ultrasound (LUS) can play an important role in the management of patients with SARS-CoV2-related pneumonia, expanding from the initial diagnosis to the subsequent monitoring and follow-up. Among many other potential advantages (such has the absence of ionizing radiation, its inherent costeffectiveness, and bedside repeatability), LUS provides immediate diagnostic response and might prevent the risk of spreading the infection by moving the patient from the Emergency Room to the Radiology facilities. Aim of this short review is to define the potential role of lung ultrasound in Covid-19 patients, according to the evidence in the medical literature