Significance of Lung Ultrasound in Patients with Suspected COVID-19 Infection at Hospital Admission

Gutsche, Holger; Lesser, Thomas G.; Wolfram, Frank; Doenst, Torsten

doi:10.3390/diagnostics11060921

Cited by 13 publications

(21 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the 27 hospitalists invited to interview, a total of 22 (15 adopters, 7 non-adopters) were enrolled and participated in interviews that lasted 30 to 45 min (Table 2). Median years post-residency of participants was 10.5 [IQR: [5][6][7][8][9][10][11][12][13][14][15]. Recruited hospitalists had a broad spectrum of LUS experience ranging from novices to experts who routinely used LUS for diagnosis of multiple disease processes, including pneumothorax, pneumonia, pleural effusion, and pulmonary edema.…”

Section: Resultsmentioning

confidence: 99%

“…LUS has been shown to have multiple advantages over the current first-line imaging modality, chest x-ray, including increased accuracy and avoidance of ionizing radiation in diagnosis of some of the most common causes of dyspnea [1]: pleural effusion [9], pneumonia [10], pulmonary edema [11] and pneumothorax [12]. The COVID pandemic has underscored the many clinical advantages of LUS, as it is an accurate diagnostic tool for the diagnosis and monitoring of COVID-pneumonia with the added potential benefit of reducing the risk of COVID exposure for radiology staff [13,14]. In light of the growing evidence of its utility, multiple professional societies now endorse LUS use in acute care settings [1,15].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hospitalist Perceptions of Barriers to Lung Ultrasound Adoption in Diverse Hospital Environments

Maw

Morris

et al. 2021

Diagnostics

View full text Add to dashboard Cite

Despite the many advantages of lung ultrasound (LUS) in the diagnosis and management of patients with dyspnea, its adoption among hospitalists has been slow. We performed semi-structured interviews of hospitals from four diverse health systems in the United States to understand determinants of adoption within a range of clinical settings. We used the diffusion of innovation theory to guide a framework analysis of the data. Of the 27 hospitalists invited, we performed 22 interviews from four hospitals of diverse types. Median years post-residency of interviewees was 10.5 [IQR:5-15]. Four main themes emerged: (1) There are important clinical advantages to LUS despite operator dependence, (2) LUS enhances patient and clinician experience, (3) Investment of clinician time to learn and perform LUS is a barrier to adoption but yields improved efficiency for the health system and (4) Mandated training and use may be necessary to achieve broad adoption as monetary incentives are less effective. Despite the perceived benefits of LUS for patients, clinicians and health systems, a significant barrier to broad LUS adoption is the experience of time scarcity by hospitalists. Future implementation strategies should focus on changes to the clinical environment that address clinician barriers to learning and adoption of new skills.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hospitalist Perceptions of Barriers to Lung Ultrasound Adoption in Diverse Hospital Environments

Maw

Morris

et al. 2021

Diagnostics

View full text Add to dashboard Cite

show abstract

“…In previously published papers, LUS has been established as an excellent diagno technique in COVID 19 pneumonia, although there are limited data available concern lung ultrasound as a prognostic tool for poor outcomes [14][15][16][17][18][19]. A study by Falgaron al.…”

Section: Discussionmentioning

confidence: 99%

“…In previously published papers, LUS has been established as an excellent diagnostic technique in COVID 19 pneumonia, although there are limited data available concerning lung ultrasound as a prognostic tool for poor outcomes [ 14 , 15 , 16 , 17 , 18 , 19 ]. A study by Falgarone et al even suggests that LUS has a better prognostic value for oxygen requirements than a chest CT scan, which is considered a gold standard for COVID-19 pneumonia [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Role of Lung Ultrasound in Predicting Clinical Severity and Fatality in COVID-19 Pneumonia

Škopljanac

Ivelja

Barčot

et al. 2021

JPM

View full text Add to dashboard Cite

Background: Lung ultrasound (LUS) is a useful imaging method for identifying COVID-19 pneumonia. The aim of this study was to explore the role of LUS in predicting the severity of the disease and fatality in patients with COVID-19. Methods: This was a single-center, follow-up study, conducted from 1 November 2020, to 22 March 2021. The LUS protocol was based on the assessment of 14 lung zones with a total score up to 42, which was compared to the disease severity and fatality. Results: A total of 133 patients with COVID-19 pneumonia confirmed by RT-PCR were enrolled, with a median time from hospital admission to lung ultrasound of one day. The LUS score was correlated with clinical severity at hospital admission (Spearman’s rho 0.40, 95% CI 0.24 to 0.53, p < 0.001). Patients with higher LUS scores were experiencing greater disease severity; a high flow nasal cannula had an odds ratio of 1.43 (5% CI 1.17–1.74) in patients with LUS score > 29; the same score also predicted the need for mechanical ventilation (1.25, [1.07–1.48]). An LUS score > 30 (1.41 [1.18–1.68]) and age over 68 (1.26 [1.11–1.43]) were significant predictors of fatality. Conclusions: LUS at hospital admission is shown to have a high predictive power of the severity and fatality of COVID-19 pneumonia.

show abstract

The Value of Lung Ultrasound to Detect the Early Pleural and Pulmonary Pathologies in Nonhospitalized COVID‐19‐Suspected Cases in a Population With a Low Prevalence of COVID‐19 Infection: A Prospective Study in 297 Subjects

Zadeh

Dietrich

et al. 2021

J of Ultrasound Medicine

View full text Add to dashboard Cite

Objectives This prospective study aimed to evaluate the value of B‐mode lung ultrasound (LUS) for the early diagnosis of coronavirus disease 2019 (COVID‐19) infection in nonhospitalized COVID‐19 suspected cases in a population with a low prevalence of disease. Methods From April 2020 to June 2020, in an ambulatory testing center for COVID‐19‐suspected cases, 297 subjects were examined by LUS before a nasopharyngeal swab was taken for a reverse transcription polymerase chain reaction (RT‐PCR) test. The following LUS findings were defined as pathological ultrasound findings and were analyzed: the presence of 1) pleural effusion, 2) B‐lines, 3) fragmented visceral pleura, 4) consolidation, and 5) air bronchogram in the consolidation. The LUS findings were compared with the RT‐PCR test results. Results The result of the RT‐PCR test for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) was positive in 11 and negative in 286 subjects, and the prevalence of COVID‐19 infection in the study participants was 3.7%. On LUS, a pathological finding could be detected in 56/297 (18.9%) study participants. The LUS revealed a sensitivity of 27.3%, a specificity of 81.5%, a positive predictive value of 5.4%, a negative predictive value of 96.7%, and a diagnostic accuracy of 79.9% for the identification of COVID‐19 infection. Conclusions For the identification of COVID‐19 infection, LUS is highly sensitive to the patient spectrum and to the prevalence of the disease. Due to the low diagnostic performance in nonhospitalized COVID‐19 cases in low‐prevalence areas, LUS cannot be considered to be an adequate method for making a diagnosis in this group.

show abstract

Significance of Lung Ultrasound in Patients with Suspected COVID-19 Infection at Hospital Admission

Cited by 13 publications

References 23 publications

Hospitalist Perceptions of Barriers to Lung Ultrasound Adoption in Diverse Hospital Environments

Hospitalist Perceptions of Barriers to Lung Ultrasound Adoption in Diverse Hospital Environments

Role of Lung Ultrasound in Predicting Clinical Severity and Fatality in COVID-19 Pneumonia

The Value of Lung Ultrasound to Detect the Early Pleural and Pulmonary Pathologies in Nonhospitalized COVID‐19‐Suspected Cases in a Population With a Low Prevalence of COVID‐19 Infection: A Prospective Study in 297 Subjects

Contact Info

Product

Resources

About