Clinical outcomes and lung ultrasound findings in COVID-19 follow up: Calm comes after the storm?

Gurbani, Nikita; Acosta-Sorensen, Marco; Díaz-Pérez, David; Figueira-Goncalves, Juan Marco; Ramallo-Fariña, Yolanda; Trujillo-Castilla, José Luis

doi:10.1016/j.resmer.2022.100907

Cited by 3 publications

(4 citation statements)

References 27 publications

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“…They were analyzed for all intents and purposes, taking into account the leukocytes, lymphocytes, neutrophils, monocytes, thrombocytes, ESR, LDH, AST, CRP, fibrinogen, procalcitonin, ferritin, D-dimer and IL-6. From all laboratory findings, LDH, D-dimer and IL-6 levels were correlated with the lung ultrasound score with higher statistical evidence [26,27]. Additionally, higher IL-6 levels were found in patients with less severe forms of SARS-CoV-2 infection, according to Salton and colleagues [26].…”

Section: Discussionmentioning

confidence: 85%

COVID-19 in Infants and Children under 2 Years—Could Lung Ultrasound Score Be Correlated with Biomarkers and Symptoms?

Stoicescu,

Lovrenski,

Iacob

et al. 2023

Biomedicines

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Introduction: It is already well known that infants and children infected with COVID-19 develop mild to moderate forms of the disease, with fever and oropharyngeal congestion being the most common symptoms. However, there are instances when patients claim to be experiencing respiratory symptoms. Because of the repeated lung examinations required in these situations, non-irradiating imaging techniques are preferred. This study’s objective is to ascertain the value of lung ultrasonography (LUS) in the medical management of these specific cases. Methods: Infants and children under two years old with SARS-CoV-2 infection were evaluated using LUS. Patients with other respiratory pathologies were excluded by using specific tests. The LUS score (LUSS) was correlated with biomarkers and clinical findings using the Mann–Whitney U test and Spearman’s rank correlation rho. Results: The LUSS for each patient varied from 1 to 8 points out of a maximum of 36 points. The arithmetic mean was 4.47 ± 2.36 (S.D), while the 95% CI for the arithmetic mean was 3.33 to 5.61. Sparse B-lines were present in all enrolled infants and children (100%), while only 36.84% developed alveolar syndrome (confluent B-lines). The lung changes were correlated with their biomarkers, specifically inflammatory markers. The correlation between LUSS and LDH, D-dimers, and IL-6 was a strongly positive one with rho = 0.55 (p = 0.001, 95% CI 0.13 to 0.80) between the LUSS and D-dimer levels and rho = 0.60 (p = 0.03, 95% CI 0.04 to 0.87) between LUSS and D-dimer levels at symptomatic infants and children (with respiratory involvement). Conclusions: Infants and children under the age of two are prone to develop mild forms of COVID-19 disease with a B-line pattern on LUS, although inflammatory markers have elevated blood levels. Despite the small sample, D-dimer levels and O2 saturation were correlated with LUSS in patients with respiratory involvement, while similar results were also found in the entire lot.

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Section: Discussionmentioning

confidence: 85%

COVID-19 in Infants and Children under 2 Years—Could Lung Ultrasound Score Be Correlated with Biomarkers and Symptoms?

Stoicescu,

Lovrenski,

Iacob

et al. 2023

Biomedicines

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“…The full text was assessed in 349 studies and 72 were selected for data extraction. After reviewing these papers, 50 were deemed eligible for qualitative assessment [ 8 , 23 – 71 ] and 47 were included in the meta-analysis [ 8 , 23 , 24 , 26 – 57 , 59 – 63 , 65 – 71 ]. 11 studies which had potentially overlapping patient populations [ 72 – 83 ] were removed.…”

Section: Resultsmentioning

confidence: 99%

“…23 studies imaged patients in early (3 months) follow-up and 24 studies imaged patients at late (>3 months) follow-up. Only four studies used non-CT-based technology (ultrasound, MRI, plain radiography or scintigraphy) [ 30 , 36 , 53 , 71 ]. The study that employed scintigraphy also performed CT in the same patients [ 53 ].…”

Section: Resultsmentioning

confidence: 99%

Post-COVID-19 dyspnoea and pulmonary imaging: a systematic review and meta-analysis

et al. 2023

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BackgroundA proportion of coronavirus disease 2019 (COVID-19) survivors experience persistent dyspnoea without measurable impairments in lung function. We performed a systematic review and meta-analysis to determine relationships between dyspnoea and imaging abnormalities over time in post-COVID-19 patients.MethodsUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we analysed studies published prior to 15 September 2022 and indexed by Google Scholar, PubMed and LitCOVID which assessed chest imaging in adults ≥3 months after COVID-19. Demographic, chest imaging, spirometric and post-COVID-19 symptom data were extracted. The relationships between imaging abnormalities and dyspnoea, sex and age were determined using a random effects model and meta-regression.Results47 studies were included in the meta-analysis (n=3557). The most prevalent computed tomography (CT) imaging abnormality was ground-glass opacities (GGOs) (44.9% (95% CI 37.0–52.9%) at any follow-up time-point). Occurrence of reticulations significantly decreased between early and late follow-up (p=0.01). The prevalence of imaging abnormalities was related to the proportion of patients with dyspnoea (p=0.012). The proportion of females was negatively correlated with the presence of reticulations (p=0.001), bronchiectasis (p=0.001) and consolidations (p=0.025). Age was positively correlated with imaging abnormalities across all modalities (p=0.002) and imaging abnormalities present only on CT (p=0.001) (GGOs (p=0.004) and reticulations (p=0.001)). Spirometric values improved during follow-up but remained within the normal range at all time-points.ConclusionsImaging abnormalities were common 3 months after COVID-19 and their occurrence was significantly related to the presence of dyspnoea. This suggests that CT imaging is a sensitive tool for detecting pulmonary abnormalities in patients with dyspnoea, even in the presence of normal spirometric measurements.

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“…This progress has significant implications for enhancing patient care, especially considering the challenge of treating patients at home for evolving lung illness post-admission throughout the COVID-19 pandemic. LUS played a substantial role in the assessment of such patients in the community [53,54] in the acute setting [55] and the post-illness follow-up [56].…”

Section: Discussionmentioning

confidence: 99%

Can Dialysis Patients Identify and Diagnose Pulmonary Congestion Using Self-Lung Ultrasound?

Schneider,

Maimon,

Hasidim

et al. 2023

JCM

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Background: With the recent developments in automated tools, smaller and cheaper machines for lung ultrasound (LUS) are leading us toward the potential to conduct POCUS tele-guidance for the early detection of pulmonary congestion. This study aims to evaluate the feasibility and accuracy of a self-lung ultrasound study conducted by hemodialysis (HD) patients to detect pulmonary congestion, with and without artificial intelligence (AI)-based automatic tools. Methods: This prospective pilot study was conducted between November 2020 and September 2021. Nineteen chronic HD patients were enrolled in the Soroka University Medical Center (SUMC) Dialysis Clinic. First, we examined the patient’s ability to obtain a self-lung US. Then, we used interrater reliability (IRR) to compare the self-detection results reported by the patients to the observation of POCUS experts and an ultrasound (US) machine with an AI-based automatic B-line counting tool. All the videos were reviewed by a specialist blinded to the performer. We examined their agreement degree using the weighted Cohen’s kappa (Kw) index. Results: A total of 19 patients were included in our analysis. We found moderate to substantial agreement between the POCUS expert review and the automatic counting both when the patient performed the LUS (Kw = 0.49 [95% CI: 0.05–0.93]) and when the researcher performed it (Kw = 0.67 [95% CI: 0.67–0.67]). Patients were able to place the probe in the correct position and present a lung image well even weeks from the teaching session, but did not show good abilities in correctly saving or counting B-lines compared to an expert or an automatic counting tool. Conclusions: Our results suggest that LUS self-monitoring for pulmonary congestion can be a reliable option if the patient’s count is combined with an AI application for the B-line count. This study provides insight into the possibility of utilizing home US devices to detect pulmonary congestion, enabling patients to have a more active role in their health care.

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Clinical outcomes and lung ultrasound findings in COVID-19 follow up: Calm comes after the storm?

Cited by 3 publications

References 27 publications

COVID-19 in Infants and Children under 2 Years—Could Lung Ultrasound Score Be Correlated with Biomarkers and Symptoms?

COVID-19 in Infants and Children under 2 Years—Could Lung Ultrasound Score Be Correlated with Biomarkers and Symptoms?

Post-COVID-19 dyspnoea and pulmonary imaging: a systematic review and meta-analysis

Can Dialysis Patients Identify and Diagnose Pulmonary Congestion Using Self-Lung Ultrasound?

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