Modified Lung Ultrasound Score in Evaluating the Severity of Covid-19 Pneumonia

Sümbül, Hilmi Erdem; Koç, Ayşe Selcan; Pinar, Arzu; Aslan, Muhammed Zübeyir; Gulumsek, Erdinc; Koca, Hasan; Bulut, Yurdaer; Karakoç, Emre; Turunç, Tuba; Bayrak, Edip; Ozturk, Huseyin Ali; Avcı, Akkan; Ünal, İ̇lker; İçen, Yahya Kemal; Koç, Mevlüt; Şahin, Ahmet Rıza; Okyay, Ramazan Azim

doi:10.1016/j.ultrasmedbio.2021.04.023

Cited by 9 publications

(3 citation statements)

References 20 publications

(52 reference statements)

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“…Of interest, besides chest X-ray and CT scan, lung ultrasonography has been pointed as a cost-effective non-invasive approach to assess pulmonary involvement in the scenario of a pandemic. 17 According Sumbul et al 18 the PaO2/FiO2 value, which is an important indicator for ARDS and respiratory support requirements, and mLUS were found to have a close and significant relationship. Pleural effusion is a rare imaging finding, according to Carubbi et al 19 And none of their patients showed concurrent lymphadenopathy.…”

Section: Discussionmentioning

confidence: 97%

Prevalence of Acute Kidney Injury in Covid-19 Patients- Retrospective Single-Center Study

Bashir¹,

Mukhtar

Mohamed

et al. 2022

IDR

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Introduction In December 2019, a coronavirus disease 2019 (COVID-19) disease outbreak started in Wuhan, Hubei Province, China, and spread rapidly to other regions of the world. Although diffuse alveolar injury and acute respiratory failure were the most prominent characteristics, further investigation of organ involvement is essential. Aim In this study, we aim to determine the prevalence of acute kidney injury (AKI) in covid-19 patients and also the relationship between inflammatory markers, the severity of lung involvement, and acute kidney injury in COVID-19 patients. Methods This was a retrospective analysis of 102 COVID-19 patients presented to a tertiary teaching hospital in Mogadishu during the second wave of Covid-19 2021. Patients’ age, gender, comorbidities, hemoglobin, platelet, and white blood cell counts, glucose, urea, creatinine, sodium, potassium, CRP, ferritin, real-time polymerase chain reaction (RT PCR) Covid-19 test and CT scan findings were all collected. Results The mean age of the patients was 58 (Range 23–91 years), including 64 men and 38 women. The prevalence of acute kidney injury was 12.7%. There was a significant association between acute kidney injury, CRP and ferritin with the p values of P<0.003 and P<0.004, respectively. For severity of lung involvement with computed tomography finding, 35 (34.3%) had mild, 35 (34.3%) had moderate and 32 (31.4%) had severe lung involvement. There was significant association between the lung involvement, Ferritin and CRP levels with P values of P<0.005 and P<0.007 respectively. Conclusion Our findings indicate that acute kidney injury is common in covid-19 patients and can increase the morbidity and mortality of these patients. As a result, clinicians in low-resource countries such as Somalia should be more vigilant about kidney injury in patients with severe COVID-19.

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Section: Discussionmentioning

confidence: 97%

Prevalence of Acute Kidney Injury in Covid-19 Patients- Retrospective Single-Center Study

Bashir¹,

Mukhtar

Mohamed

et al. 2022

IDR

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“…Типичные ультразвуковые признаки пневмонии были определены и популяризированы в работах основоположника направления D. Lichtenstein, а также в согласительных консенсусах [18][19][20][21][22] 2021) при использовании 12-зонного протокола ультразвуковой индекс поражения коррелировал с индексом Горовица (P/F) на фоне ингаляции кислородом (R2 0,68; p < 0,0001) и P/F при дыхании атмосферным воздухом (R2 0,59; p < 0,0001) [25]. Примерно такую же корреляцию (R2 −0,697; p < 0,0001) ультразвукового индекса и P/F выявляли Sumbul H. et al (2021) [26].…”

Section: Discussionunclassified

Ultrasound-guided lung lesion index as a predictor of treatment outcomes: cohort study of 388 patients with coronavirus infection

Lakhin¹,

Zhirnova

Щеголев³

et al. 2022

Annals of Critical Care

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INTRODUCTION. Currently there are a lot of articles of lung ultrasound (LUS) in COVID-19 both in the diagnosis and in the prognosis of the disease. OBJECTIVE. Evaluation of the relationship between the ultrasound-guided lung lesion index (UIL) with the volume of lung involvement determined by computed tomography (CT) and disease outcomes in patients with COVID-19. MATERIALS AND METHODS. A prospective observational cohort clinical study included 388 patients aged 18-75 years; diagnosed with pneumonia with COVID-19 or suspected COVID-19. Lung ultrasound was performed according to the 16-zone “Russian Protocol” within 24 hours after CT scan of the chest organs. RESULTS. The median lung lesion volume on CT was 55 (35-74) % and UIL was 46 (28-60) points. UIL had a strong direct correlation of 0.873 (95 % CI 0.842-0.897, p < 0.01) with the change in the volume of lung involvement determined by CT and the inverse with the SpO2/FiO2 index - 0.850 (95 % CI 0.827-0.871, p < 0.01). Mortality was 56 patients (14.4 %) (p = 0.018). The optimal cut-off point for ROC analysis in predicting mortality was 55 points and had a sensitivity of 97.6 % and a specificity of 73.9 % with an area under the curve of 0.896 (95 % CI 0.861-0.931). Kaplan- Meier analysis on the entire data set (n = 388) demonstrated a survival rate of 97.6 % in the group with a UIL score less than 55 points and 62 % in the group with a UIL score more than 55 points. Differences between groups were statistically significant (Log Rank test p < 0.001; Breslow test p < 0.001). As a result, multivariate Cox regression analysis, using the stepwise exclusion method, only UIL remained a significant predictor of adverse outcome (p < 0.01). CONCLUSIONS. UIL determined by 16-zone “Russian protocol” correlated with severity of respiratory failure and volume of lung injury and was a predictor of adverse prognosis of disease outcome.

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“…Thereby, almost every element of the treatment chain-from the prehospital setting to the ICUs-is affected. Several existing and novel LUS (lung ultrasound) protocols were published [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15], ultrasound-and CT-based studies [1,4,[16][17][18][19][20][21] were dealing with the disease-pathognomonic patterns, their types, localization and distribution. Although there is a clear association between CT scan findings and disease severity, in the critically ill, unstable patients it is quite challenging to perform these scans: transporting the patients is relatively unsafe [22] and requires complete staff.…”

Section: Introductionmentioning

confidence: 99%

Reliability and clinical correlations of semi-quantitative lung ultrasound on BLUE points in COVID-19 mechanically ventilated patients: The ‘BLUE-LUSS’—A feasibility clinical study

et al. 2022

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Introduction Bedside lung ultrasound has gained a key role in each segment of the treatment chain during the COVID-19 pandemic. During the diagnostic assessment of the critically ill patients in ICUs, it is highly important to maximize the amount and quality of gathered information while minimizing unnecessary interventions (e.g. moving/rotating the patient). Another major factor is to reduce the risk of infection and the workload of the staff. Objectives To serve these significant issues we constructed a feasibility study, in which we used a single-operator technique without moving the patient, only assessing the easily achievable lung regions at conventional BLUE points. We hypothesized that calculating this ‘BLUE lung ultrasound score’ (BLUE-LUSS) is a reasonable clinical tool. Furthermore, we used both longitudinal and transverse scans to measure their reliability and assessed the interobserver variability as well. Methods University Intensive Care Unit based, single-center, prospective, observational study was performed on 24 consecutive SARS-CoV2 RT-PCR positive, mechanically ventilated critically ill patients. Altogether 400 loops were recorded, rated and assessed off-line by 4 independent intensive care specialists (each 7+ years of LUS experience). Results Intraclass correlation values indicated good reliability for transversal and longitudinal qLUSS scores, while we detected excellent interrater agreement of both cLUSS calculation methods. All of our LUS scores correlated inversely and significantly to the P/F values. Best correlation was achieved in the case of longitudinal qLUSS (r = -0.55, p = 0.0119). Conclusion Summarized score of BLUE-LUSS can be an important, easy-to-perform adjunct tool for assessing and quantifying lung pathology in critically ill ventilated patients at bedside, especially for the P/F ratio. The best agreement for the P/F ratio can be achieved with the longitudinal scans. Regarding these findings, assessing BLUE-points can be extended with the BLUE-LUSS for daily routine using both transverse and longitudinal views.

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Modified Lung Ultrasound Score in Evaluating the Severity of Covid-19 Pneumonia

Cited by 9 publications

References 20 publications

Prevalence of Acute Kidney Injury in Covid-19 Patients- Retrospective Single-Center Study

Prevalence of Acute Kidney Injury in Covid-19 Patients- Retrospective Single-Center Study

Ultrasound-guided lung lesion index as a predictor of treatment outcomes: cohort study of 388 patients with coronavirus infection

Reliability and clinical correlations of semi-quantitative lung ultrasound on BLUE points in COVID-19 mechanically ventilated patients: The ‘BLUE-LUSS’—A feasibility clinical study

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