Thiago Thomaz Mafort1,2, Rogério Rufino1,2, Claudia Henrique da Costa1,2, Mariana Soares da Cal1, Laura Braga Monnerat1, Patrícia Frascari Litrento1, Laura Lizeth Zuluaga Parra1, Arthur de Sá Earp de Souza Marinho1, Agnaldo José Lopes3,4,5. 1. Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro, Av. Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil. 2. Postgraduate Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro, Av. Prof. Manuel de Abreu, 444, 2° andar, Vila Isabel, Rio de Janeiro, 20550-170, Brazil. 3. Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro, Av. Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil. agnaldolopes.uerj@gmail.com. 4. Postgraduate Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro, Av. Prof. Manuel de Abreu, 444, 2° andar, Vila Isabel, Rio de Janeiro, 20550-170, Brazil. agnaldolopes.uerj@gmail.com. 5. Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rua Dona Isabel, 94, Bonsucesso, Rio de Janeiro, 21032-060, Brazil. agnaldolopes.uerj@gmail.com.
Abstract
BACKGROUND: The role of lung ultrasound (LUS) in evaluating the mid- and long-term prognoses of patients with COVID-19 pneumonia is not yet known. The objectives of this study were to evaluate associations between LUS signs at the time of screening and clinical outcomes 1 month after LUS and to assess LUS signs at the time of presentation with known risk factors for COVID-19 pneumonia. METHODS: This was a retrospective study of data prospectively collected 1 month after LUS screening of 447 adult patients diagnosed with COVID-19 pneumonia. Sonographic examination was performed in screening tents with the participants seated. The LUS signs (B-lines > 2, coalescent B-lines, and subpleural consolidations) were captured in six areas of each hemithorax and a LUS aeration score was calculated; in addition, the categories of disease probability based on patterns of LUS findings (high-probability, intermediate-probability, alternate, and low-probability patterns) were evaluated. The LUS signs at patients' initial evaluation were related to the following outcomes: symptomatology, the need for hospitalization or invasive mechanical ventilation (IMV), and COVID-19-related death. RESULTS: According to the evaluations performed 1 month after LUS screening, 36 patients were hospitalised, eight of whom required intensive care unit (ICU) admission and three of whom died. The presence of coalescent B-lines was associated with the need for hospitalization (p = 0.008). The presence of subpleural consolidations was associated with dyspnoea (p < 0.0001), cough (p = 0.003), the need for hospitalization (p < 0.0001), the need for ICU admission (p < 0.0001), and death (p = 0.002). A higher aeration score was associated with dyspnoea (p < 0.0001), the need for hospitalization (p < 0.0001), the need for ICU admission (p < 0.0001), and death (p = 0.003). In addition, patients with a high-probability LUS pattern had a higher aeration score (p < 0.0001) and more dyspnoea (p = 0.024) and more often required hospitalization (p < 0.0001) and ICU admission (p = 0.031). CONCLUSIONS: In patients with COVID-19 pneumonia, LUS signs were related to respiratory symptoms 1 month after LUS screening. Strong relationships were identified between LUS signs and the need for hospitalization and death.
BACKGROUND: The role of lung ultrasound (LUS) in evaluating the mid- and long-term prognoses of patients with COVID-19 pneumonia is not yet known. The objectives of this study were to evaluate associations between LUS signs at the time of screening and clinical outcomes 1 month after LUS and to assess LUS signs at the time of presentation with known risk factors for COVID-19 pneumonia. METHODS: This was a retrospective study of data prospectively collected 1 month after LUS screening of 447 adult patients diagnosed with COVID-19 pneumonia. Sonographic examination was performed in screening tents with the participants seated. The LUS signs (B-lines > 2, coalescent B-lines, and subpleural consolidations) were captured in six areas of each hemithorax and a LUS aeration score was calculated; in addition, the categories of disease probability based on patterns of LUS findings (high-probability, intermediate-probability, alternate, and low-probability patterns) were evaluated. The LUS signs at patients' initial evaluation were related to the following outcomes: symptomatology, the need for hospitalization or invasive mechanical ventilation (IMV), and COVID-19-related death. RESULTS: According to the evaluations performed 1 month after LUS screening, 36 patients were hospitalised, eight of whom required intensive care unit (ICU) admission and three of whom died. The presence of coalescent B-lines was associated with the need for hospitalization (p = 0.008). The presence of subpleural consolidations was associated with dyspnoea (p < 0.0001), cough (p = 0.003), the need for hospitalization (p < 0.0001), the need for ICU admission (p < 0.0001), and death (p = 0.002). A higher aeration score was associated with dyspnoea (p < 0.0001), the need for hospitalization (p < 0.0001), the need for ICU admission (p < 0.0001), and death (p = 0.003). In addition, patients with a high-probability LUS pattern had a higher aeration score (p < 0.0001) and more dyspnoea (p = 0.024) and more often required hospitalization (p < 0.0001) and ICU admission (p = 0.031). CONCLUSIONS: In patients with COVID-19 pneumonia, LUS signs were related to respiratory symptoms 1 month after LUS screening. Strong relationships were identified between LUS signs and the need for hospitalization and death.
Authors: Fernando de Freitas Martins; Diego G Bassani; Daniel Ibarra Rios; Maura Helena F Resende; Dany Weisz; Amish Jain; Jose Maria de Andrade Lopes; Patrick J McNamara Journal: J Ultrasound Med Date: 2020-10-12 Impact factor: 2.153
Authors: Andrea Smargiassi; Gino Soldati; Elena Torri; Federico Mento; Domenico Milardi; Paola Del Giacomo; Giuseppe De Matteis; Maria Livia Burzo; Anna Rita Larici; Maurizio Pompili; Libertario Demi; Riccardo Inchingolo Journal: J Ultrasound Med Date: 2020-08-20 Impact factor: 2.153
Authors: Giovanni Battista Fonsi; Paolo Sapienza; Gioia Brachini; Chiara Andreoli; Maria Luisa De Cicco; Bruno Cirillo; Simona Meneghini; Francesco Pugliese; Daniele Crocetti; Enrico Fiori; Andrea Mingoli Journal: J Ultrasound Med Date: 2020-09-07 Impact factor: 2.153
Authors: Marco Allinovi; Alberto Parise; Martina Giacalone; Andrea Amerio; Marco Delsante; Anna Odone; Andrea Franci; Fabrizio Gigliotti; Silvia Amadasi; Davide Delmonte; Niccolò Parri; Angelo Mangia Journal: Ultrasound Med Biol Date: 2020-07-20 Impact factor: 2.998
Authors: Peter M George; Lisa G Spencer; Shaney L Barratt; Robin Condliffe; Sujal R Desai; Anand Devaraj; Ian Forrest; Michael A Gibbons; Nicholas Hart; R Gisli Jenkins; Danny F McAuley; Brijesh V Patel; Erica Thwaite Journal: Thorax Date: 2020-08-24 Impact factor: 9.139
Authors: Bruce J Kimura; Rujing Shi; Eric M Tran; Samantha R Spierling Bagsic; Pamela M Resnikoff Journal: J Ultrasound Med Date: 2021-09-02 Impact factor: 2.754