Prediction Accuracy of Serial Lung Ultrasound in COVID-19 Hospitalized Patients (Pred-Echovid Study)

Torres‐Macho, Juan; Sánchez-Fernández, Marcos; Arnanz-González, Irene; Tung‐Chen, Yale; Franco-Moreno, Ana Isabel; Duffort‐Falcó, Mercedes; Romero, Luisa; Rodríguez-Suárez, Santiago; Bernabéu-Wittel, Máximo; Urbano, Elena; Méndez‐Bailón, Manuel; Roque-Rojas, Fernando; García-Guijarro, Elena; García-Casasola, G

doi:10.3390/jcm10214818

Cited by 18 publications

(21 citation statements)

References 29 publications

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“…Recently, LUS has proved its efficiency in the dynamic monitoring of COVID-19 pneumonia, as well as in the follow-up of patients recovered from this infection [ 63 , 64 ]. Moreover, a recent review proves the usefulness of hand-held ultrasound equipment, which has the advantage of lower acquisition costs and that is easy to decontaminate, which is a necessary activity nowadays [ 65 ].…”

Section: Discussionmentioning

confidence: 99%

Is Lung Ultrasound Helpful in COVID-19 Neonates?—A Systematic Review

et al. 2021

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Background: The SARS-CoV-2 infection has occurred in neonates, but it is a fact that radiation exposure is not recommended given their age. The aim of this review is to assess the evidence on the utility of lung ultrasound (LUS) in neonates diagnosed with COVID-19. Methods: A systematic literature review was performed so as to find a number of published studies assessing the benefits of lung ultrasound for newborns diagnosed with COVID and, in the end, to make a comparison between LUS and the other two more conventional procedures of chest X-rays or CT exam. The key terms used in the search of several databases were: “lung ultrasound”, “sonography”, “newborn”, “neonate”, and “COVID-19′. Results: In total, 447 studies were eligible for this review, and after removing the duplicates, 123 studies referring to LU were further examined, but only 7 included cases of neonates. These studies were considered for the present research paper. Conclusions: As a non-invasive, easy-to-use, and reliable method for lung lesion detection in neonates with COVID-19, lung ultrasound can be used as a useful diagnosis tool for the evaluation of COVID-19-associated lung lesions. The benefits of this method in this pandemic period are likely to arouse interest in opening new research horizons, with immediate practical applicability.

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Section: Discussionmentioning

confidence: 99%

Is Lung Ultrasound Helpful in COVID-19 Neonates?—A Systematic Review

et al. 2021

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“…In the last decades, LUS has proven to be a suitable alternative to conventional radiological methods in multiple kinds of lung diseases (24)(25)(26)(27). During the current pandemic, numerous studies have reported the usefulness of LUS as a front-line tool in the diagnosis and management of SARS-CoV-2 acute pneumonia (28)(29)(30)(31). However, its applicability in the detection of post-COVID-19 interstitial sequelae is yet to be defined.…”

Section: Introductionmentioning

confidence: 99%

Lung Ultrasound as a First-Line Test in the Evaluation of Post-COVID-19 Pulmonary Sequelae

et al. 2022

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Background: Interstitial lung sequelae are increasingly being reported in survivors of COVID-19 pneumonia. An early detection of these lesions may help prevent the development of irreversible lung fibrosis. Lung ultrasound (LUS) has shown high diagnostic accuracy in interstitial lung disease (ILD) and could likely be used as a first-line test for post-COVID-19 lung sequelae.Methods: Single-center observational prospective study. Follow-up assessments of consecutive patients hospitalized for COVID-19 pneumonia were conducted 2–5 months after the hospitalization. All patients underwent pulmonary function tests (PFTs), high-resolution computed tomography (HRCT), and LUS. Radiological alterations in HRCT were quantified using the Warrick score. The LUS score was obtained by evaluating the presence of pathological B-lines in 12 thoracic areas (range, 0–12). The correlation between the LUS and Warrick scores was analyzed.Results: Three hundred and fifty-two patients who recovered from COVID-19 pneumonia were recruited between July and September 2020. At follow-up, dyspnea was the most frequent symptom (69.3%). FVC and DLCO alterations were present in 79 (22.4%) and 234 (66.5%) patients, respectively. HRCT showed relevant interstitial lung sequelae (RILS) in 154 (43.8%) patients (Warrick score ≥ 7). The LUS score was strongly correlated with the HRCT Warrick score (r = 0.77) and showed a moderate inverse correlation with DLCO (r = −0.55). The ROC curve analysis revealed that a LUS score ≥ 3 indicated an excellent ability to discriminate patients with RILS (sensitivity, 94.2%; specificity, 81.8%; negative predictive value, 94.7%).Conclusions: LUS could be implemented as a first-line procedure in the evaluation of Post-COVID-19 interstitial lung sequelae. A normal LUS examination rules out the presence of these sequelae in COVID-19 survivors, avoiding the need for additional diagnostic tests such as HRCT.

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“…While these results suggest clinicians felt the potential advantages of LUS did not consistently outweigh barriers to use in the management of all patients with COVID-19, it is important to note that the perceived barriers are likely dynamic. For instance, lack of evidence for support of LUS in COVID-19 could change with time as there have been multiple studies demonstrating utility in COVID-19 published since our pilot ended [34][35][36]. This may allow a more targeted approach to utilize LUS in the COVID-19 patients who would most benefit.…”

Section: Discussionmentioning

confidence: 99%

Using Iterative RE-AIM to enhance hospitalist adoption of lung ultrasound in the management of patients with COVID-19: an implementation pilot study

Maw

Morris

Glasgow

et al. 2022

Implement Sci Commun

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Background Lung ultrasound (LUS) is a clinician-performed evidence-based imaging modality that has multiple advantages in the evaluation of dyspnea caused by multiple disease processes, including COVID-19. Despite these advantages, few hospitalists have been trained to perform LUS. The aim of this study was to increase adoption and implementation of LUS during the 2020 COVID-19 pandemic by using recurrent assessments of RE-AIM outcomes to iteratively revise our implementation strategies. Methods In an academic hospital, we implemented guidelines for the use of LUS in patients with COVID-19 in July 2020. Using a novel “RE-AIM dashboard,” we used an iterative process of evaluating the high-priority outcomes of Reach, Adoption, and Implementation at twice monthly intervals to inform revisions of our implementation strategies for LUS delivery (i.e., Iterative RE-AIM process). Using a convergent mixed methods design, we integrated quantitative RE-AIM outcomes with qualitative hospitalist interview data to understand the dynamic determinants of LUS Reach, Adoption, and Implementation. Results Over the 1-year study period, 453 LUSs were performed in 298 of 12,567 eligible inpatients with COVID-19 (Reach = 2%). These 453 LUS were ordered by 43 out of 86 eligible hospitalists (LUS order adoption = 50%). However, the LUSs were performed/supervised by only 8 of these 86 hospitalists, 4 of whom were required to complete LUS credentialing as members of the hospitalist procedure service (proceduralist adoption 75% vs 1.2% non-procedural hospitalists adoption). Qualitative and quantitative data obtained to evaluate this Iterative RE-AIM process led to the deployment of six sequential implementation strategies and 3 key findings including (1) there were COVID-19-specific barriers to LUS adoption, (2) hospitalists were more willing to learn to make clinical decisions using LUS images than obtain the images themselves, and (3) mandating the credentialing of a strategically selected sub-group may be a successful strategy for improving Reach. Conclusions Mandating use of a strategically selected subset of clinicians may be an effective strategy for improving Reach of LUS. Additionally, use of Iterative RE-AIM allowed for timely adjustments to implementation strategies, facilitating higher levels of LUS Adoption and Reach. Future studies should explore the replicability of these preliminary findings.

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Prediction Accuracy of Serial Lung Ultrasound in COVID-19 Hospitalized Patients (Pred-Echovid Study)

Cited by 18 publications

References 29 publications

Is Lung Ultrasound Helpful in COVID-19 Neonates?—A Systematic Review

Is Lung Ultrasound Helpful in COVID-19 Neonates?—A Systematic Review

Lung Ultrasound as a First-Line Test in the Evaluation of Post-COVID-19 Pulmonary Sequelae

Using Iterative RE-AIM to enhance hospitalist adoption of lung ultrasound in the management of patients with COVID-19: an implementation pilot study

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