A multisystem approach by bed-side ultrasound in patients with COVID-19 infection: a case series

Abstract

Recent epidemiological reports on Chinese population affected by novel coronavirus showed a wide spread of clinical and biochemical alterations, suggesting a relationship between progression of lung damage to acute respiratory distress syndrome and the systemic inflammatory response, triggering an irreversible multiple organ damage and disseminated intravascular coagulation. Bedside ultrasound assessment provides integrated information, describing a multisystemic and dynamic clinical scenario for every patient. Furthermore, this approach allows to concentrate multiple information in the hands of a single operator, also limiting the risk of exposure to infection for healthcare professionals. As per our experience, herewith reported, we described the characteristics of 10 patients with SARS-CoV-2 infection. Ultrasound findings were related to clinical information, blood test analysis, and results of instrumental tests, such as chest X-ray and chest CT. According to our ultrasound data, COVID-19 appears to be a systemic pathology even in those cases of mild to moderate disease. By this multisystem ultrasound approach, we could immediately recognize patients with a diffuse organ involvement and a more severe clinical pattern; moreover, we can protect healthcare workers and limit infection within health facilities.

Massive pulmonary embolism masked as an episode of acute agitation in a psychiatric patient: a case report

“…15 However, the differential diagnosis of pulmonary embolism has recently become complicated considering the typical clinical presentation of COVID-19 pneumonia. [16][17][18] Furthermore, it is well known that the management of the psychiatric patient with psychomotor agitation in the emergency room is extremely complex. The differential diagnosis underlying episodes of acute agitation is broad and sometimes difficult to execute.…”