Lung ultrasound in the diagnosis of COVID-19 infection - A case series and review of the literature

Buda, Natalia; Segura‐Grau, Elena; Cylwik, Jolanta; Wełnicki, Marcin

doi:10.1016/j.advms.2020.06.005

Cited by 33 publications

(29 citation statements)

References 30 publications

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“…Point‐of‐care ultrasound (POCUS) has been considered as a safe and effective bedside option in the initial evaluation, management, and monitoring of disease progression in patients with confirmed or suspected COVID‐19 infection 46 . A review from Buda et al 47 showed that POCUS could be considered for patients with suspected COVID‐19 whose PCR test result is negative. Besides, ultrasound examination may be worth considering because of its convenience, low cost, and safety (compares with CT scanning).…”

Section: Discussionmentioning

confidence: 99%

Consistency of recommendations and methodological quality of guidelines for the diagnosis and treatment of COVID‐19

Luo

Liu

Ren

et al. 2021

J Evidence Based Medicine

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Objective Since the beginning of the COVID‐19 epidemic, a large number of guidelines on diagnosis and treatment of COVID‐19 have been developed, but the quality of those guidelines and the consistency of recommendations are unclear. The objective of this study is to evaluate the quality of the diagnosis and treatment guidelines on COVID‐19 and analyze the consistency of the recommendations of these guidelines. Methods We searched for guidelines on diagnosis and/or treatment of COVID‐19 through PubMed, CBM, CNKI, and WanFang Data, from January 1, 2020 to August 31, 2020. In addition, we also searched official websites of the US CDC, European CDC and WHO, and some guideline collection databases. We included diagnosis and/or treatment guidelines for COVID‐19, including rapid advice guidelines and interim guidelines. Two trained researchers independently extracted data and four trained researchers evaluated the quality of the guidelines using the AGREE II instruments. We extracted information on the basic characteristics of the guidelines, guideline development process, and the recommendations. We described the consistency of the direction of recommendations for treatment and diagnosis of COVID‐19 across the included guidelines. Results A total of 37 guidelines were included. Most included guidelines were assessed as low quality, with only one of the six domains of AGREE II (clarity of presentation) having a mean score above 50%. The mean scores of three domains (stakeholder involvement, the rigor of development and applicability) were all below 30%. The recommendations on diagnosis and treatment were to some extent consistent between the included guidelines. Computed tomography (CT), X‐rays, lung ultrasound, RT‐PCR, and routine blood tests were the most commonly recommended methods for COVID‐19 diagnosis. Thirty guidelines were on the treatment of COVID‐19. The recommended forms of treatment included supportive care, antiviral therapy, glucocorticoid therapy, antibiotics, immunoglobulin, extracorporeal membrane oxygenation (ECMO), convalescent plasma, and psychotherapy. Conclusions The methodological quality of currently available diagnosis and treatment guidelines for COVID‐19 is low. The diagnosis and treatment recommendations between the included guidelines are highly consistent. The main diagnostic methods for COVID‐19 are RT‐PCR and CT, with ultrasound as a potential diagnostic tool. As there is no effective treatment against COVID‐19 yet, supportive therapy is at the moment the most important treatment option.

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Section: Discussionmentioning

confidence: 99%

Consistency of recommendations and methodological quality of guidelines for the diagnosis and treatment of COVID‐19

Luo

Liu

Ren

et al. 2021

J Evidence Based Medicine

View full text Add to dashboard Cite

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“…Chest x-ray to detect lung involvement has low sensitivity, and CT chest should be considered when there is a respiratory compromise. 50,51 However, in the COVID-19 pandemic, the use of ultrasound for the detection of viral pneumonia has gained significant popularity and may detect changes earlier than a routine chest X-ray. 52…”

Section: Radiologymentioning

confidence: 99%

COVID 19 infection: Pediatric perspectives

et al. 2021

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The coronavirus disease 2019 (COVID‐19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has rapidly spread across the globe, causing innumerable deaths and a massive economic catastrophe. Exposure to household members with confirmed COVID‐19 is the most common source of infection among children. Children are just as likely as adults to get infected with SARS‐CoV‐2. Most children are asymptomatic and when symptoms occur, they are usually mild. Infants <12 months old are at a higher risk for severe or critical disease. COVID‐19 is diagnosed the same way in pediatric population as adults by testing specimen obtained from upper respiratory tract for nucleic acid amplification test (NAAT) using reverse transcriptase viral polymerase chain reaction (RT‐PCR). The common laboratory findings in hospitalized patient include leukopenia, lymphopenia, and increased levels of inflammatory markers. Chest X‐ray findings are variable and computed tomography scans of the chest may show ground glass opacities similar to adults or non‐specific findings. Prevention is the primary intervention strategy. Recently the U.S. Food and Drug Administration (FDA) has provided emergency authorization of the Pfizer‐BioNTech COVID‐19 vaccine and many other vaccine candidates are in the investigational stage. There is limited data in children on the use of antivirals, hydroxychloroquine, azithromycin, monoclonal antibody, and convalescent plasma. Oxygen therapy is required in hypoxic children (saturation <92%). Similar to adults, other measures to maintain oxygenation such as high flow nasal cannula, CPAP, or ventilatory support may be needed. Ventilatory management strategies should include use of low tidal volumes (5–6 cc/kg), high positive expiratory pressure, adequate sedation, paralysis, and prone positioning. Recently, a new entity associated with COVID‐19 called multisystem inflammatory syndrome in children (MIS‐C) has emerged. Clinical, laboratory, and epidemiological criteria are the basis for this diagnosis. Management options include ICU admission, steroids, intravenous gamma globulin, aspirin, anakinra, and anticoagulants. Vasoactive‐inotropic score (VIS) is used to guide vasopressor support.

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“…Lung ultrasound is emerging as a promising point-of-care tool to diagnose COVID-19 and efforts to standardize the use of this modality have come forth ( 13 ). Although it has several advantages compared to CT scans including the absence of radiation, lower cost, portability, and lower contamination risk, perhaps the most significant challenge with the use of lung ultrasound remains to be its potential for subjectivity and its reliance on the experience and expertise of the sonographer ( 14 , 15 ). In resource-constrained settings where trained personnel are not readily available, treatment decision-making and resource allocation may need to rely on more objective bases for the diagnosis of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 in cancer patients can be challenging to screen in a resource limited setting

Ting

Sacdalan

Cortez

et al. 2020

Cancer Treatment and Research Communications

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During this COVID-19 pandemic, patients with symptoms such as fever, cough, sore throat, and coryza were advised to have RT-PCR testing for SARS-CoV-2 infection. We described here an elderly female with chronic lymphocytic leukemia, who presented with atypical symptoms that were not directly attributable to COVID-19. This patient was admitted to the non-COVID-19 ward for supportive care. Later, her chest x-ray revealed pneumonia that was confirmed to be COVID-19 by RT-PCR testing several days later. In resource-poor settings where molecular testing results suffered from delays or were altogether unavailable, the use of diagnostic imaging such as a chest x-ray could serve as a quick guide in the assessment and management of these patients especially if the imaging results suggest COVID-19 infection.

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Lung ultrasound in the diagnosis of COVID-19 infection - A case series and review of the literature

Cited by 33 publications

References 30 publications

Consistency of recommendations and methodological quality of guidelines for the diagnosis and treatment of COVID‐19

Consistency of recommendations and methodological quality of guidelines for the diagnosis and treatment of COVID‐19

COVID 19 infection: Pediatric perspectives

COVID-19 in cancer patients can be challenging to screen in a resource limited setting

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