Predicción de evolución desfavorable en pacientes hospitalizados por COVID-19 mediante ecografía pulmonar

Ramos-Hernández, Cristina; Rial, Maribel Botana; Area, Luis Alberto Pazos; Fernández, Marta Núñez; Fernández, Silvia Pérez; González, M. Gentil; Casal, Manuel Crespo; Villar, Alberto Fernández

doi:10.1016/j.arbres.2020.07.043

Cited by 10 publications

(7 citation statements)

References 20 publications

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“…A study by Falgaron al. even suggests that LUS has a better prognostic value for oxygen requirements tha chest CT scan, which is considered a gold standard for COVID-19 pneumonia [24].…”

Section: Discussionmentioning

confidence: 99%

“…In previously published papers, LUS has been established as an excellent diagnostic technique in COVID 19 pneumonia, although there are limited data available concerning lung ultrasound as a prognostic tool for poor outcomes [ 14 , 15 , 16 , 17 , 18 , 19 ]. A study by Falgarone et al even suggests that LUS has a better prognostic value for oxygen requirements than a chest CT scan, which is considered a gold standard for COVID-19 pneumonia [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…We chose an LUS examination protocol with 14 lung regions suggested by Soldati et al, which differs slightly from 10 and 12 lung region protocols used in other previously mentioned studies [ 21 ]. A study by Hernandez et al suggests that the 14-lung-region protocol is superior to other protocols [ 24 ]. Although this might tend to require a more extensive patient workload, we have used this advantageously and noticed two things: (i) COVID19 pneumonia tends to be more severe if apical regions are affected; and (ii) infiltration of the middle regions seem to correlate with the highest respiratory modality used, even better than the whole LUS score ( Supplementary File S6 ).…”

Section: Discussionmentioning

confidence: 99%

“…There have been some suggestions lately that LUS can predict outcomes in COVID-19; endpoints in most of studies were mortality and the need for invasive mechanical ventilation [ 19 , 20 , 21 , 22 , 23 , 24 ]. At the beginning of the COVID-19 pandemic, it was observed that LUS did not correlate much with oxygen need in patients at the time of admission to a hospital ward.…”

Section: Introductionmentioning

confidence: 99%

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Role of Lung Ultrasound in Predicting Clinical Severity and Fatality in COVID-19 Pneumonia

Škopljanac

Ivelja

Barčot

et al. 2021

JPM

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Background: Lung ultrasound (LUS) is a useful imaging method for identifying COVID-19 pneumonia. The aim of this study was to explore the role of LUS in predicting the severity of the disease and fatality in patients with COVID-19. Methods: This was a single-center, follow-up study, conducted from 1 November 2020, to 22 March 2021. The LUS protocol was based on the assessment of 14 lung zones with a total score up to 42, which was compared to the disease severity and fatality. Results: A total of 133 patients with COVID-19 pneumonia confirmed by RT-PCR were enrolled, with a median time from hospital admission to lung ultrasound of one day. The LUS score was correlated with clinical severity at hospital admission (Spearman’s rho 0.40, 95% CI 0.24 to 0.53, p < 0.001). Patients with higher LUS scores were experiencing greater disease severity; a high flow nasal cannula had an odds ratio of 1.43 (5% CI 1.17–1.74) in patients with LUS score > 29; the same score also predicted the need for mechanical ventilation (1.25, [1.07–1.48]). An LUS score > 30 (1.41 [1.18–1.68]) and age over 68 (1.26 [1.11–1.43]) were significant predictors of fatality. Conclusions: LUS at hospital admission is shown to have a high predictive power of the severity and fatality of COVID-19 pneumonia.

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“…A study by Falgaron al. even suggests that LUS has a better prognostic value for oxygen requirements tha chest CT scan, which is considered a gold standard for COVID-19 pneumonia [24].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Role of Lung Ultrasound in Predicting Clinical Severity and Fatality in COVID-19 Pneumonia

Škopljanac

Ivelja

Barčot

et al. 2021

JPM

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“…It is striking that LUS has been considered by different scientific societies as one of the key imaging tests in the acute phase of the disease, both to establish the diagnosis ( 11 ) and its prognosis ( 25 ). However, the protocols ( 8 , 26 ) published to date for the follow-up of possible sequelae recommend X-ray as the first imaging test to be used.…”

Section: Discussionmentioning

confidence: 99%

Multicentre study on the accuracy of lung ultrasound in the diagnosis and monitoring of respiratory sequelae in the medium and long term in patients with COVID-19

Ramos Hernández,

Tilve Gomez,

Sánchez Fernández

et al. 2023

Front. Med.

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IntroductionLung ultrasound (LUS) has proven to be a more sensitive tool than radiography (X-ray) to detect alveolar-interstitial involvement in COVID-19 pneumonia. However, its usefulness in the detection of possible pulmonary alterations after overcoming the acute phase of COVID-19 is unknown. In this study we proposed studying the utility of LUS in the medium- and long-term follow-up of a cohort of patients hospitalized with COVID-19 pneumonia.Materials and methodsThis was a prospective, multicentre study that included patients, aged over 18 years, at 3 ± 1 and 12 ± 1 months after discharge after treatment for COVID-19 pneumonia. Demographic variables, the disease severity, and analytical, radiographic, and functional clinical details were collected. LUS was performed at each visit and 14 areas were evaluated and classified with a scoring system whose global sum was referred to as the “lung score.” Two-dimensional shear wave elastography (2D-SWE) was performed in 2 anterior areas and in 2 posterior areas in a subgroup of patients. The results were compared with high-resolution computed tomography (CT) images reported by an expert radiologist.ResultsA total of 233 patients were included, of whom 76 (32.6%) required Intensive Care Unit (ICU) admission; 58 (24.9%) of them were intubated and non-invasive respiratory support was also necessary in 58 cases (24.9%). Compared with the results from CT images, when performed in the medium term, LUS showed a sensitivity (S) of 89.7%, specificity (E) 50%, and an area under the curve (AUC) of 78.8%, while the diagnostic usefulness of X-ray showed an S of 78% and E of 47%. Most of the patients improved in the long-term evaluation, with LUS showing an efficacy with an S of 76% and E of 74%, while the X-ray presented an S of 71% and E of 50%. 2D-SWE data were available in 108 (61.7%) patients, in whom we found a non-significant tendency toward the presentation of a higher shear wave velocity among those who developed interstitial alterations, with a median kPa of 22.76 ± 15.49) versus 19.45 ± 11.39; p = 0.1).ConclusionLung ultrasound could be implemented as a first-line procedure in the evaluation of interstitial lung sequelae after COVID-19 pneumonia.

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Ultrasound findings of lung ultrasonography in COVID-19: A systematic review

Gil-Rodríguez

Rojas

Aranda-Laserna

et al. 2022

European Journal of Radiology

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Purpose To identify the defining lung ultrasound (LUS) findings of COVID-19, and establish its association to the initial severity of the disease and prognostic outcomes. Method Systematic review was conducted according to the PRISMA guidelines. We queried PubMed, Embase, Web of Science, Cochrane Database and Scopus using the terms ((coronavirus) OR (covid-19) OR (sars AND cov AND 2) OR (2019-nCoV)) AND ((“lung ultrasound”) OR (LUS)), from 31st of December 2019 to 31st of January 2021. PCR-confirmed cases of SARS-CoV-2 infection, obtained from original studies with at least 10 participants 18 years old or older, were included. Risk of bias and applicability was evaluated with QUADAS-2. Results We found 1333 articles, from which 66 articles were included, with a pooled population of 4687 patients. The most examined findings were at least 3 B-lines, confluent B-lines, subpleural consolidation, pleural effusion and bilateral or unilateral distribution. B-lines, its confluent presentation and pleural abnormalities are the most frequent findings. LUS score was higher in intensive care unit (ICU) patients and emergency department (ED), and it was associated with a higher risk of developing unfavorable outcomes (death, ICU admission or need for mechanical ventilation). LUS findings and/or the LUS score had a good negative predictive value in the diagnosis of COVID-19 compared to RT-PCR. Conclusions The most frequent ultrasound findings of COVID-19 are B-lines and pleural abnormalities. High LUS score is associated with developing unfavorable outcomes. The inclusion of pleural effusion in the LUS score and the standardisation of the imaging protocol in COVID-19 LUS remains to be defined.

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Predicción de evolución desfavorable en pacientes hospitalizados por COVID-19 mediante ecografía pulmonar

Abstract: Graphical abstract

Cited by 10 publications

References 20 publications

Role of Lung Ultrasound in Predicting Clinical Severity and Fatality in COVID-19 Pneumonia

Role of Lung Ultrasound in Predicting Clinical Severity and Fatality in COVID-19 Pneumonia

Multicentre study on the accuracy of lung ultrasound in the diagnosis and monitoring of respiratory sequelae in the medium and long term in patients with COVID-19

Ultrasound findings of lung ultrasonography in COVID-19: A systematic review

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