Bedside wireless lung ultrasound for the evaluation of COVID-19 lung injury in senior nursing home residents

Abstract

Lung Ultrasound (LUS) is regarded to be potentially useful to diagnose lung injury in older adults living in nursing homes with suspected COVID-19 pneumonia. We aimed at evaluating presence lung injury among senior nursing home residents by LUS performed with portable wireless scanner echography. The study population consisted of 150 residents with a mean age of 88 years (85% female) residing in 12 nursing homes in Northern Italy. Subjects had to have a history of recent onset of symptoms compatible with COVID-19 pneumonia or have been exposed to the contagion of patients carrying the disease. COVID-19 testing was performed with SARS-CoV-2 nasal-pharyngeal (NP) swabs. Positive subjects to LUS scanning were considered those with non-coascelent B-lines in >3 zones, coalescent B-lines in >3 zones and with iperdensed patchy non-consolidated lungs. Sixty-three percent had positive NP testing and 65% had LUS signs of pulmonary injury. LUS had a sensitivity of 79% in predicting positive NP testing. Sixteen percent of residents tested negative for SARSCoV-2 carried the signs of COVID-19 lung injury at LUS. There were 92 patients (61%) with current or recent symptoms.Positivity to LUS scanning was reported in 73% of residents with symptoms, while it was 53% in those without (P=0.016). A positive NP testing was observed in 66% of residents with symptoms and in 57% of those without (P=0.27). We conclude that assessment of LUS by portable wireless scanner echography can be profitability utilized to diagnose lung injury among senior nursing home residents with or without symptoms compatible with COVID-19 pneumonia.

Point-of-Care Ultrasound (POCUS) Predicts Clinical Outcomes in Patients with COVID-19

“…19 The sonographic manifestations of COVID-19 pneumonia include bilateral B-lines, subpleural consolidations, pleural thickening, yet with surprising absence of pleural effusions. [20][21][22] These findings correlate with findings highly specific for COVID-19 observed with computed tomography (see Appendix for a full description of these sonographic findings and their CT correlates). 20,22 There are few studies that examine the predictive utility of POCUS for COVID-19 despite recent findings that suggest imaging modalities may aid in risk stratification.…”

Nursing homes during the COVID-19 pandemic: a scoping review of challenges and responses

“…A study suggested that PPE shortages were more evident in private nursing homes compared to state-owned facilities [ 33 ]. This could be in relation to the different financial challenges experienced by these two different types of nursing homes [ 33 ], as well as external issues that generally affected the procurement and supply of PPE [ 35 ]. In the UK, it was argued that the primary PPE purchaser role of the NHS through the health care budget may have inadvertently undermined the procurement of PPE by nursing homes, which mostly depend on the social care budget and private income [ 36 ].…”

Hand-Held Ultrasound of the Lung: A Systematic Review

“…Four hundred and fifty-three articles were retrieved from all search bibliographic databases and 15 studies were evaluated (Figure 1): Bedetti et al [18], Kajimoto et al [19], Lisi et al [20], Cogliati et al [21], Filopei et al [22], Platz et al [23], Sforza et al [24], Phillips and Manning [25], Bobbia et al [26], Bensted et al [27], Lima et al [28], Newhouse et al [29], Jalil et al [30] Dini et al [31], Bennett et al [32].…”

“…Five out of the 15 studies were conducted in Italy [15,17,18,25,32,33] and in most cases, eligible subjects on a specific period of time [23][24][25][26]28,[30][31][32] were evaluated with a hand-held US device (Table 1). In the majority of cases, the role of the index test (namely HHUS, hand-held ultrasound) was diagnostic [19][20][21][22][23][24]26,27,30,32,33] followed by screening [28,29,32] and only one study as triage [24].…”