Use of pulmonary ultrasound to predict in-hospital mortality in patients with COVID-19 infection

Manzur‐Sandoval, Daniel; García‐Cruz, Edgar; Gopar‐Nieto, Rodrigo; Araiza-Garaygordobil, Diego; Maza, Arturo Garza-de la; Ramírez-Lara, Edith; Zebadua-Torres, Rodrigo; Barajas-Campos, Ricardo Leopoldo; Rascón-Sabido, Rafael; Mendoza-Copa, Gastón; Chango-Criollo, Esteban I; Ramírez-Galindo, Gabriela; Rojas‐Velasco, Gustavo

doi:10.24875/gmm.m21000554

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Full‐text screening yielded 56 articles from which data was subsequently extracted (Figure 1). The characteristics of the included studies are presented in Table [11–63]. Most studies are retrospective, they have a wide distribution worldwide in Italy, Japan, China, Netherlands.…”

Section: Resultsmentioning

confidence: 99%

Prognostic and discriminatory abilities of imaging scoring systems in predicting COVID‐19 adverse outcomes

Kandil,

Elgenidy,

Saba

et al. 2023

iRADIOLOGY

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Background To evaluate the discriminatory ability of imaging modalities' scoring systems in the prediction of COVID‐19 adverse outcomes like ICU admission, ventilatory support, or mortality. Methods We searched PUBMED, EBSCO, WEB OF SCIENCE, and SCOPUS. Two authors independently screened the resulting papers for fulfillment criteria. Meta‐DiSc version 1.4, RevMan version 5.4, and MedCalc version 19.1 were used for test accuracy analysis, sensitivity and specificity analysis, and pooling Area under the curve for discriminatory assessment, respectively. Results Regarding mortality prediction, the computed tomography (CT) showed significantly higher sensitivity [80%; 95% CI 0.74–0.85] and positive likelihood ratio (PLR) [4.41 95% CI 2.94–6.61] relative to the Lung Ultrasound Score (LUS) approach, while the LUS approached the CT scan with specificity of 81% [95% CI 0.78–0.83] and negative likelihood ratio (NLR) of [0.32; 95% CI 0.16–0.64]. The pooled area under ROC for LUS was [AUC = 0.777, 95% CI 0.701–0.852; p < 0.001, I2 = 74.86%, p = 0.019] while the pooled area under ROC for CT severity score was [AUC = 0.855, 95% CI 0.78–0.93; p < 0.001, I2 = 93.73%, p < 0.001]. Regarding adverse outcomes prediction, the LUS had a slightly higher specificity of [78%; 95% CI 0.75–0.80] and PLR of [3.60; 95% CI 2.28–5.68] compared to CT score. The pooled AUC using LUS was (0.77, 95% CI 0.719–0.832; p < 0.001), while using CT severity score was (0.843, 95% CI 0.787–0.898; p < 0.001), and using X‐ray scores was (0.814, 95% CI 0.751–0.878; p < 0.001). Conclusion CT severity score showed a better discriminatory ability in predicting COVID‐19 adverse outcomes, as in‐hospital mortality, ICU admission, and need for ventilatory support compared to LUS and X‐RAY scores, while the LUS, being more specific, had a slightly better prognostic value.

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Section: Resultsmentioning

confidence: 99%

Prognostic and discriminatory abilities of imaging scoring systems in predicting COVID‐19 adverse outcomes

Kandil,

Elgenidy,

Saba

et al. 2023

iRADIOLOGY

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“…A higher LUS score was associated with the need for intensive respiratory support or mechanical ventilation, SpO 2 /FiO 2 ratio below 357 as well as length of stay of ≥9 days ( 21 ). A multiple logistic regression model from a Mexican cohort by Manzur-Sandoval et al found that an LUS score of ≥19 was significantly associated with mortality (hazard ratio =2.55) ( 93 ). Meanwhile, a study by Lugara et al on Southern Italian COVID-19 patients found that increased LUS score correlated with elevated lactate levels and an increased need for ventilation ( 94 ).…”

Section: Discussionmentioning

confidence: 99%

Point-of-care ultrasound use in COVID-19: a narrative review

Chua,

Boon,

Yeoh

et al. 2024

Ann Transl Med

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Background and Objective The coronavirus disease 2019 (COVID-19) pandemic that began in early 2020 resulted in significant mortality from respiratory tract infections. Existing imaging modalities such as chest X-ray (CXR) lacks sensitivity in its diagnosis while computed tomography (CT) scan carries risks of radiation and contamination. Point-of-care ultrasound (POCUS) has the advantage of bedside testing with higher diagnostic accuracy. We aim to describe the various applications of POCUS for patients with suspected severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in the emergency department (ED) and intensive care unit (ICU). Methods We performed literature search on the use of POCUS in the diagnosis and management of COVID-19 in MEDLINE, Embase and Scopus databases using the following search terms: “ultrasonography”, “ultrasound”, “COVID-19”, “SARS-CoV-2”, “SARS-CoV-2 variants”, “emergency services”, “emergency department” and “intensive care units”. Search was performed independently by two reviewers with any discrepancy adjudicated by a third member. Key Content and Findings Lung POCUS in patients with COVID-19 shows different ultrasonographic features from pulmonary oedema, bacterial pneumonia, and other viral pneumonia, thus useful in differentiating between these conditions. It is more sensitive than CXR, and more accessible and widely available than CT scan. POCUS can be used to diagnose COVID-19 pneumonia, screen for COVID-19-related pulmonary and extrapulmonary complications, and guide management of ICU patients, such as timing of ventilator weaning based on lung POCUS findings. Conclusions POCUS is a useful and rapid point-of-care modality that can be used to aid in diagnosis, management, and risk stratification of COVID-19 patients in different healthcare settings.

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“…En cuanto a la valoración ecográfica pulmonar llevada a cabo en la serie de casos analizados en este estudio, se puede observar que es un excelente indicador de evolución, ya que puntuaciones > 7 fueron consideradas con curso desfavorable y los pacientes requirieron ventilación mecánica invasiva. Esto coincide con lo reportado por Bobillo et al 32 en pacientes pediátricos, así como con otro estudio en población adulta, en el cual las puntuaciones LUS > 6 tuvieron una mala evolución 33 .…”

Section: Discussionunclassified

Gravedad y complicaciones en lactantes con infección por el virus respiratorio sincitial posterior a la pandemia por SARS-CoV-2

Gastelum-Bernal,

Mondragón-González,

Peñuñuri-Ballesteros

et al. 2024

BMHIM

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Introducción: Posterior a la pandemia por SARS-CoV-2 se ha observado un incremento en la hospitalización por virus respiratorio sincitial (VRS), con mayores complicaciones. Se han encontrado alteraciones extrapulmonares asociadas, disfunción biventricular y lesión renal aguda, entre otras. El objetivo de este estudio fue analizar la evolución y las complicaciones en niños hospitalizados con enfermedad respiratoria de vías bajas secundaria a infección por VRS tras la pandemia de COVID-19. Métodos: Se incluyeron todos los menores de 2 años que ingresaron al servicio de urgencias con infección por VRS. Se analizaron las características clínicas, la necesidad de oxígeno suplementario, el uso de aminas, el índice de angina renal y el requerimiento de terapia de sustitución renal. Se realizó ecografía pulmonar al ingreso. En el análisis estadístico, para las variables cuantitativas se determinaron la media y la desviación estándar, y para las variables cualitativas la frecuencia y el porcentaje. Se evaluaron las diferencias de la distribución con la prueba exacta de Fisher. Resultados: Hubo 45 pacientes con infección por VRS. El 26.7% requirieron ventilación mecánica invasiva y el 11.1% diálisis peritoneal. La letalidad fue de cuatro casos, tres de ellos menores de 12 meses con puntuación de LUS > 7; esto contrasta con el 90.2% de los sobrevivientes con puntaje < 7 (p = 0.0004). Conclusiones: Se observó un aumento en la incidencia de bronquiolitis tras la pandemia, en más de la mitad de los casos con cuadros de moderados a graves, y todos requirieron oxígeno suplementario al ingreso. La lesión renal aguda fue la manifestación extrapulmonar más frecuente.

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Use of pulmonary ultrasound to predict in-hospital mortality in patients with COVID-19 infection

Cited by 4 publications

References 7 publications

Prognostic and discriminatory abilities of imaging scoring systems in predicting COVID‐19 adverse outcomes

Prognostic and discriminatory abilities of imaging scoring systems in predicting COVID‐19 adverse outcomes

Point-of-care ultrasound use in COVID-19: a narrative review

Gravedad y complicaciones en lactantes con infección por el virus respiratorio sincitial posterior a la pandemia por SARS-CoV-2

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