et al. with the exception of a pre-symptomatic phase. 7 CT findings begin as single or multifocal ground-glass opacities, pulmonary nodules, or air bronchograms, which progress with development of interlobular septal thickening and crazy paving, before regression in both size and density at the end of the second week of infection. Opacities often have extensive distribution, typically bilaterally, but also seen unilaterally, with occasional round morphology or reversed-halo or atoll sign. 5 In the dissipation phase, there may be continued patchy consolidative opacities in addition to reticular "strip-like" opacities, bronchial wall thickening, and interlobular septal thickening. 1,8 The characteristic ultrasound findings (bilateral and multilobar B-lines, subpleural consolidates, irregular pleural line, and decreased blood flow 3,4,9 ) have been shown to be highly consistent with CT findings 3,4 and can be expected to develop over a similar timeline. During the first few days of symptom presentation, scattered unilateral or bilateral multilobar B-lines can be visualised. 3,9 As the disease progresses from the end of week 1 through week 2, development of alveolar interstitial syndrome with diffuse, bilateral B-lines can occur in addition to an irregular pleural line with punctate defects and formation of subpleural consolidations with visible air bronchograms. Lastly, after the end of week 2 during convalescence, there can be an expected regression of prior findings with re-emergence of A-lines. 9 A summary of findings is listed in Table 1.Although the literature remains limited, there is still a clear benefit for clinicians to be familiar with ultrasound findings and their progression in COVID-19 patients. It may be particularly useful in helping emergency personnel to triage and diagnose suspected patients, 4 but also for monitoring progression of the disease throughout hospitalisation. Additionally, it offers substantial benefits in comparison to CT imaging, including portability, lower cost, reduced radiation, and ease of sterilisation. Physicians are encouraged to be familiar with and to utilise lung ultrasound in the management of COVID-19 patients.

To compare the prognostic value and reproducibility of visual versus AI-assisted analysis of lung involvement on submillisievert low-dose chest CT in COVID-19 patients. Materials and Methods: This was a HIPAA-compliant, institutional review board-approved retrospective study. From March 15 to June 1, 2020, 250 RT-PCR confirmed COVID-19 patients were studied with low-dose chest CT at admission. Visual and AI-assisted analysis of lung involvement was performed by using a semi-quantitative CT score and a quantitative percentage of lung involvement. Adverse outcome was defined as intensive care unit (ICU) admission or death. Cox regression analysis, Kaplan-Meier curves, and cross-validated receiver operating characteristic curve with area under the curve (AUROC) analysis was performed to compare model performance. Intraclass correlation coefficients (ICCs) and Bland-Altman analysis was used to assess intra-and interreader reproducibility. Results: Adverse outcome occurred in 39 patients (11 deaths, 28 ICU admissions). AUC values from AI-assisted analysis were significantly higher than those from visual analysis for both semiquantitative CT scores and percentages of lung involvement (all P<0.001). Intrareader and interreader agreement rates were significantly higher for AI-assisted analysis than visual analysis (all ICC 0.960 versus 0.885). AI-assisted variability for quantitative percentage of lung involvement was 17.2% (coefficient of variation) versus 34.7% for visual analysis. The sample size to detect a 5% change in lung involvement with 90% power and an  error of 0.05 was 250 patients with AI-assisted analysis and 1014 patients with visual analysis. Conclusion: AI-assisted analysis of lung involvement on submillisievert low-dose chest CT outperformed conventional visual analysis in predicting outcome in COVID-19 patients while I n p r e s s 3 reducing CT variability. Lung involvement on chest CT could be used as a reliable metric in future clinical trials.

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Two cases of carcinosarcoma of the lung are presented. Until now, 76 cases have been recorded in the literature. The lesion contains an epithelial and a mesenchymal component, both with cytologic features of malignancy. A central endobronchial and a peripheral invasive type have been described. Fiberoptic biopsies usually show no tumour at all or contain only one of the two components. Treatment consists of lobectomy or pneumonectomy. Prognosis is not better for this tumour than for non-small cell bronchogenic carcinoma, and may even be worse.

Since its introduction in the 1970s in the United States, outpatient parenteral antibiotic/antimicrobial therapy (OPAT) has been adopted internationally for long-term intravenous (IV) treatment of stable infectious diseases. The aim is to provide a safe and successful completion of IV antimicrobial treatment at the ambulatory care center or at home without complications and costs associated with hospitalization. OPAT implementation has been accelerated by progress in vascular access devices, newly available antibiotics, the emphasis on cost-savings, as well as an improved patient comfort and a reduced incidence of health care associated infections with a similar outcome. OPAT utilization is supported by an extensive published experience and guidelines of the British Society of Antimicrobial Chemotherapy and the Infectious Diseases Society of America for adults as well as for children. Despite these recommendations and its widespread adoption, in Belgium OPAT is only fully reimbursed and established for cystic fibrosis patients. Possible explanations for this unpopularity include physician unfamiliarity and a lack of uniform funding arrangements with higher costs for the patient. This article aims to briefly review benefits, risks, indications, financial impact for supporting OPAT in a non-university hospital as standard of care. Our experience with OPAT at the ambulatory care center of our hospital and its subsequent recent introduction in the home setting is discussed.