Assessing COVID‐19 pneumonia—Clinical extension and risk with point‐of‐care ultrasound: A multicenter, prospective, observational study

Abstract

contributed equally to this study.Registration: This study is registered with trialregister.nl, Trial NL8497.Funding and support: By JACEP Open policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist.Background: Assessing the extent of lung involvement is important for the triage and care of COVID-19 pneumonia. We sought to determine the utility of point-ofcare ultrasound (POCUS) for characterizing lung involvement and, thereby, clinical risk determination in COVID-19 pneumonia.Methods: This multicenter, prospective, observational study included patients with COVID-19 who received 12-zone lung ultrasound and chest computed tomography (CT) scanning in the emergency department (ED). We defined lung disease severity using the lung ultrasound score (LUS) and chest CT severity score (CTSS). We assessed the association between the LUS and poor outcome (ICU admission or 30-day all-cause mortality). We also assessed the association between the LUS and hospital length of stay. We examined the ability of the LUS to differentiate between disease severity groups. Lastly, we estimated the correlation between the LUS and CTSS and the interrater agreement for the LUS. We handled missing data by multiple imputation with chained equations and predictive mean matching.

Lung ultrasound in predicting COVID‐19 clinical outcomes: A prospective observational study

“…They concluded that the extend of pulmonary involvement detected by lung ultrasound were associated with poor outcome, admission duration, and disease severity. 37 …”

“… 32 , 33 , 34 , 35 Although existing data suggest the extent of pulmonary findings in POCUS correlate with disease severity, there are few studies formally assessing the predictive capabilities of POCUS in COVID‐19. 36 , 37 …”

CORONA (COre ultRasOund of Covid in iNtensive Care & Acute Medicine) Study: National Service Evaluation of Lung and Heart Ultrasound in Intensive Care Patients With Suspected or Proven COVID-19

“…Typical LUS ndings have a good correlation with COVID-19 PCR positivity. This has been well studied and published previously 29 , 30 , 31 , 32 , 33 , 34 . Preserved A-lines in all 6 zones made the diagnosis of COVID-19 related respiratory failure extremely unlikely 35 .…”

Multi-organ point-of-care ultrasound for detection of pulmonary embolism in critically ill COVID-19 patients – A diagnostic accuracy study

“…A 10–5 MHz linear transducer or 5–3 MHz curvilinear transducer with lung examination setting was used. The lung ultrasound protocol consisted of a structured assessment of 6 zones of each hemithorax [ 34 ]. The recently modified criteria from Mathis et al were used to diagnose PE in COVID-19 patients [ 14 , 18 ].…”