Point-of-Care Ultrasound in the Evaluation of COVID-19

Abrams, Eric; Rose, Gabriel; Fields, J. Matthew; Esener, Dasia

doi:10.1016/j.jemermed.2020.06.032

Cited by 28 publications

(36 citation statements)

References 12 publications

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“…Lung ultrasound (LUS) represents a suitable imaging alternative to both chest X-ray and CT scan for COVID-19 diagnosis and monitoring because it can be performed bedside (even at home) by an internist, can be easily repeated over time, and does not require sophisticated instruments or radiation [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Lung Ultrasound Patterns and Clinical-Laboratory Correlates during COVID-19 Pneumonia: A Retrospective Study from North East Italy

Senter

Capone

Pasqualin

et al. 2021

JCM

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Background and Aim. Lung ultrasound (LUS) is a convenient imaging modality in the setting of coronavirus disease-19 (COVID-19) because it is easily available, can be performed bedside and repeated over time. We herein examined LUS patterns in relation to disease severity and disease stage among patients with COVID-19 pneumonia. Methods. We performed a retrospective case series analysis of patients with confirmed SARS-CoV-2 infection who were admitted to the hospital because of pneumonia. We recorded history, clinical parameters and medications. LUS was performed and scored in a standardized fashion by experienced operators, with evaluation of up to 12 lung fields, reporting especially on B-lines and consolidations. Results. We included 96 patients, 58.3% men, with a mean age of 65.9 years. Patients with a high-risk quick COVID-19 severity index (qCSI) were older and had worse outcomes, especially for the need for high-flow oxygen. B-lines and consolidations were located mainly in the lower posterior lung fields. LUS patterns for B-lines and consolidations were significantly worse in all lung fields among patients with high versus low qCSI. B-lines and consolidations were worse in the intermediate disease stage, from day 7 to 13 after onset of symptoms. While consolidations correlated more with inflammatory biomarkers, B-lines correlated more with end-organ damage, including extrapulmonary involvement. Conclusions. LUS patterns provide a comprehensive evaluation of patients with COVID-19 pneumonia that correlated with severity and dynamically reflect disease stage. LUS patterns may reflect different pathophysiological processes related to inflammation or tissue damage; consolidations may represent a more specific sign of localized disease, whereas B-lines seem to be also dependent upon generalized illness due to SARS-CoV-2 infection.

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Section: Introductionmentioning

confidence: 99%

Lung Ultrasound Patterns and Clinical-Laboratory Correlates during COVID-19 Pneumonia: A Retrospective Study from North East Italy

Senter

Capone

Pasqualin

et al. 2021

JCM

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“…Furthermore, there is no risk of radiation and less risk of contamination (due to its’ portability), which make it a safer method compared with CT. In addition, POCUS (Point-of-Care Ultrasound) can provide vital information regarding any possible involvement of the cardiovascular system as well being used as echocardiography during the same session (29) . However, the reported sensitivity of this diagnostic tool is controversial, particularly when it is performed by a non-expert sonographist ( 30 , 31 , 32 ).…”

Section: Discussionmentioning

confidence: 99%

Correlation Between Low-Dose Chest Computed Tomography and RT-PCR Results for the Diagnosis of COVID-19: A Report of 27,824 Cases in Tehran, Iran

et al. 2021

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Rationale and Objectives Real-time polymerase chain reaction (RT-PCR) remains the gold standard for confirmation of Coronavirus disease 2019 (COVID-19) despite having many disadvantages. Here, we investigated the diagnostic performance of chest computed tomography (CT) as an alternative to RT-PCR in patients with clinical suspicion of COVID-19 infection. Methods In this descriptive cross-sectional study, 27824 patients with clinical suspicion of COVID-19 infection who underwent unenhanced low-dose chest CT from 20 February, 2020 to 21 May, 2020 were evaluated. Patients were recruited from seven specifically designated hospitals for patients with COVID-19 infection affiliated to Shahid Beheshti University of Medical Sciences. In each hospital, images were interpreted by two independent radiologists. CT findings were considered as positive/negative for COVID-19 infection based on RSNA diagnostic criteria. Then, the correlation between the number of daily positive chest CT scans and number of daily PCR-confirmed cases and COVID-19-related deaths in Tehran province during this three-month period was assessed. The trends of admission rate and patients with positive CT scans were also evaluated. Results A strong positive correlation between the numbers of daily positive CT scans and daily PCR-confirmed COVID-19 cases (r=0.913, p < 0.001) was observed. Furthermore, in hospitals located in regions with a lower socioeconomic status, the admission rate and number of positive cases within this three-month period was higher as compared to other hospitals. Conclusion Low-dose chest CT is a safe, rapid and reliable alternative to RT-PCR for the diagnosis of COVID-19 in high-prevalence regions. In addition, our study provides further evidence for considering patients’ socioeconomic status as an important risk factor for COVID-19.

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“…Cardiac involvement of the disease is very common amongst patients and the process can be either via primary viral infection or secondary activation of the immune cascade [ 14 , 23 ]. These processes directly affect cardiac function from resultant myocarditis and pulmonary embolisms (PE) [ 17 , 23 ].…”

Section: Methodsmentioning

confidence: 99%

The role of PoCUS in the assessment of COVID-19 patients

et al. 2021

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The Coronavirus disease 19 (COVID-19) pandemic has increased the burden of stress on the global healthcare system in 2020. Point of care ultrasound (PoCUS) is used effectively in the management of pulmonary, cardiac and vascular pathologies. POCUS is the use of traditional ultrasound imaging techniques in a focused binary manner to answer a specific set of clinical questions. This is an imaging technique that delivers no radiation, is inexpensive, ultraportable and provides results instantaneously to the physician operator at the bedside. In regard to the pandemic, PoCUS has played a significant adjunctive role in the diagnosis and management of co-morbidities associated with COVID-19. PoCUS also offers an alternative method to image obstetric patients and the pediatric population safely in accordance with the ALARA principle. Finally, there have been numerous PoCUS protocols describing the effective use of this technology during the COVID-19 pandemic.

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Point-of-Care Ultrasound in the Evaluation of COVID-19

Cited by 28 publications

References 12 publications

Lung Ultrasound Patterns and Clinical-Laboratory Correlates during COVID-19 Pneumonia: A Retrospective Study from North East Italy

Lung Ultrasound Patterns and Clinical-Laboratory Correlates during COVID-19 Pneumonia: A Retrospective Study from North East Italy

Correlation Between Low-Dose Chest Computed Tomography and RT-PCR Results for the Diagnosis of COVID-19: A Report of 27,824 Cases in Tehran, Iran

The role of PoCUS in the assessment of COVID-19 patients

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