Lung Ultrasonography for Risk Stratification in Patients with Coronavirus Disease 2019 (COVID-19): A Prospective Observational Cohort Study
| Autor: | Mary-Anne Hartley, Noémie Boillat-Blanco, Marie-Josée Brochu Vez, Olivier Hugli, Thomas Brahier, Olivier Pantet, Jean-Yves Meuwly, Helene Gerhard Donnet |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Coronavirus disease 2019 (COVID-19) 03 medical and health sciences 0302 clinical medicine Lower respiratory tract infection Internal medicine lus score Medicine pneumonia lung ultrasound Adult COVID-19 Humans Lung/diagnostic imaging Prospective Studies Risk Assessment SARS-CoV-2 Ultrasonography LUS score triage tool business.industry ultrasound 030208 emergency & critical care medicine Emergency department medicine.disease Triage Lung ultrasound Infectious Diseases 030228 respiratory system covid-19 Risk stratification Observational study business Cohort study |
| Zdroj: | Clinical infectious diseases, vol. 73, no. 11, pp. e4189-e4196 Clinical Infectious Diseases |
| Popis: | Background. Lung ultrasonography (LUS) is a promising pragmatic risk-stratification tool in coronavirus disease 2019 (COVID-19). This study describes and compares LUS characteristics between patients with different clinical outcomes. Methods. Prospective observational study of polymerase chain reaction-confirmed adults with COVID-19 with symptoms of lower respiratory tract infection in the emergency department (ED) of Lausanne University Hospital. A trained physician recorded LUS images using a standardized protocol. Two experts reviewed images blinded to patient outcome. We describe and compare early LUS findings ( Results. Between 6 March and 3 April 2020, we included 80 patients (17 outpatients, 42 hospitalized, and 21 intubated/dead). Seventy-three patients (91%) had abnormal LUS (70% outpatients, 95% hospitalized, and 100% intubated/dead; P = .003). The proportion of involved zones was lower in outpatients compared with other groups (median [IQR], 30% [0-40%], 44% [31-70%], 70% [50-88%]; P < .001). Predominant abnormal patterns were bilateral and there was multifocal spread thickening of the pleura with pleural line irregularities (70%), confluent B lines (60%), and pathologic B lines (50%). Posterior inferior zones were more often affected. Median normalized LUS score had a good level of discrimination between outpatients and others with area under the ROC of.80 (95% CI, .68-.92). Conclusions. Systematic LUS has potential as a reliable, cheap, and easy-to-use triage tool for the early risk stratification in patients with COVID-19 presenting to EDs. |
| Databáze: | OpenAIRE |
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