Tiziano Perrone1, Gino Soldati2, Lucia Padovini1, Anna Fiengo1, Gianluca Lettieri1, Umberto Sabatini1, Giulia Gori1, Federica Lepore1, Matteo Garolfi1, Ilaria Palumbo1, Riccardo Inchingolo3, Andrea Smargiassi3, Libertario Demi4, Elisa Eleonora Mossolani5, Francesco Tursi6, Catherine Klersy7, Antonio Di Sabatino1. 1. Department of Internal Medicine, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico San Matteo, University of Pavia, Pavia, Italy. 2. Diagnostic and Interventional Ultrasound Unit, Valle del Serchio General Hospital, Lucca, Italy. 3. Pulmonary Medicine Unit, Department of Medical and Surgical Sciences, Fondazione Serhii Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico Universitario Agostino Gemelli, Rome, Italy. 4. Department of Information Engineering and Computer Science, Ultrasound Laboratory Trento, University of Trento, Trento, Italy. 5. Emergency Medicine Unit, General Hospital Voghera, Voghera, Italy. 6. Pulmonary Medicine Unit, Codogno Hospital, Azienda Socio Sanitaria Territoriale Lodi, Codogno, Italy. 7. Service of Clinical Epidemiology and Biostatistics, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico San Matteo, University of Pavia, Pavia, Italy.
Abstract
OBJECTIVES: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can generate severe pneumonia associated with high mortality. A bedside lung ultrasound (LUS) examination has been shown to have a potential role in this setting. The purpose of this study was to evaluate the potential prognostic value of a new LUS protocol (evaluation of 14 anatomic landmarks, with graded scores of 0-3) in patients with SARS-CoV-2 pneumonia and the association of LUS patterns with clinical or laboratory findings. METHODS: A cohort of 52 consecutive patients with laboratory-confirmed SARS-CoV-2 underwent LUS examinations on admission in an internal medicine ward and before their discharge. A total LUS score as the sum of the scores at each explored area was computed. We investigated the association between the LUS score and clinical worsening, defined as a combination of high-flow oxygen support, intensive care unit admission, or 30-day mortality as the primary end point. RESULTS: Twenty (39%) patients showed a worse outcome during the observation period; the mean LUS scores ± SDs were 20.4 ± 8.5 and 29.2 ± 7.3 in patients without and with worsening, respectively (P < .001). In a multivariable analysis, adjusted for comorbidities (>2), age (>65 years), sex (male), and body mass index (≥25 kg/m2 ), the association between the LUS score and worsening (odds ratio, 1.17; 95% confidence interval, 1.05 to 1.29; P = .003) was confirmed, with good discrimination of the model (area under the receiver operating characteristic curve, 0.82). A median LUS score higher than 24 was associated with an almost 6-fold increase in the odds of worsening (odds ratio, 5.67; 95% confidence interval, 1.29 to 24.8; P = .021). CONCLUSIONS: Lung ultrasound can represent an effective tool for monitoring and stratifying the prognosis of patients with SARS-CoV-2 pulmonary involvement.
OBJECTIVES:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can generate severe pneumonia associated with high mortality. A bedside lung ultrasound (LUS) examination has been shown to have a potential role in this setting. The purpose of this study was to evaluate the potential prognostic value of a new LUS protocol (evaluation of 14 anatomic landmarks, with graded scores of 0-3) in patients with SARS-CoV-2 pneumonia and the association of LUS patterns with clinical or laboratory findings. METHODS: A cohort of 52 consecutive patients with laboratory-confirmed SARS-CoV-2 underwent LUS examinations on admission in an internal medicine ward and before their discharge. A total LUS score as the sum of the scores at each explored area was computed. We investigated the association between the LUS score and clinical worsening, defined as a combination of high-flow oxygen support, intensive care unit admission, or 30-day mortality as the primary end point. RESULTS: Twenty (39%) patients showed a worse outcome during the observation period; the mean LUS scores ± SDs were 20.4 ± 8.5 and 29.2 ± 7.3 in patients without and with worsening, respectively (P < .001). In a multivariable analysis, adjusted for comorbidities (>2), age (>65 years), sex (male), and body mass index (≥25 kg/m2 ), the association between the LUS score and worsening (odds ratio, 1.17; 95% confidence interval, 1.05 to 1.29; P = .003) was confirmed, with good discrimination of the model (area under the receiver operating characteristic curve, 0.82). A median LUS score higher than 24 was associated with an almost 6-fold increase in the odds of worsening (odds ratio, 5.67; 95% confidence interval, 1.29 to 24.8; P = .021). CONCLUSIONS: Lung ultrasound can represent an effective tool for monitoring and stratifying the prognosis of patients with SARS-CoV-2 pulmonary involvement.
Authors: Nabeel Durrani; Damjan Vukovic; Jeroen van der Burgt; Maria Antico; Ruud J G van Sloun; David Canty; Marian Steffens; Andrew Wang; Alistair Royse; Colin Royse; Kavi Haji; Jason Dowling; Girija Chetty; Davide Fontanarosa Journal: Sci Rep Date: 2022-10-20 Impact factor: 4.996
Authors: Libertario Demi; Federico Mento; Antonio Di Sabatino; Anna Fiengo; Umberto Sabatini; Veronica Narvena Macioce; Marco Robol; Francesco Tursi; Carmelo Sofia; Chiara Di Cienzo; Andrea Smargiassi; Riccardo Inchingolo; Tiziano Perrone Journal: J Ultrasound Med Date: 2021-12-03 Impact factor: 2.754