Monitoring COVID-19 patients in an internal medical ward: chest radiography, chest CT or POCUS?

Identifying commonalities in definition and governance of point-of-care ultrasound within statements from medical organizations in the United States: A scoping review for a shared understanding

This scoping review analyzed statements from 22 medical organizations in the United States to identify commonalities in the definition and governance of point-of-care ultrasound (POCUS). A total of 41 statements were included. The review found that the most commonly used elements in defining POCUS were "focused," "bedside," and "patient care." In terms of governance, consistent requirements included specific training programs, documentation in medical records, continuous quality assurance, and standards for credentialing and privileging. These findings suggest the existence of essential commonalities that could facilitate communication and the development of standardized POCUS programs in the future.

Diagnostic accuracy and prognostic value of lung ultrasound in coronavirus disease (COVID-19)

Purpose

This study aimed to assess the correlation between lung ultrasound (LUS) and computed tomography (CT) findings and the predictability of LUS scores to anticipate disease characteristics, lab data, clinical severity, and mortality in patients with COVID-19.

Material and methods

Fifty consecutive hospitalized PCR-confirmed COVID-19 patients who underwent chest CT scan and LUS on the first day of admission were enrolled. The LUS score was calculated based on the presence, severity, and distribution of parenchymal abnormalities in 14 regions.

Results

The participants’ mean age was 54.60 ± 19.93 years, and 26 (52%) were female. All patients had CT and LUS findings typical of COVID-19. The mean value of CT and LUS severity scores were 11.80 ± 3.89 (ranging from 2 to 20) and 13.74 ± 6.43 (ranging from 1 to 29), respectively. The LUS score was significantly higher in females (p = 0.016), and patients with dyspnoea (p = 0.048), HTN (p = 0.034), immunodeficiency (p = 0.034), room air SpO₂ ≤ 93 (p = 0.02), and pleural effusion (p = 0.036). LUS findings were strongly correlated with CT scan results regarding lesion type, distribution, and severity in a region-by-region fashion (92-100% agreement). An LUS score of 14 or higher was predictive of room air SpO₂ ≤ 93 and ICU admission, while an LUS score ≥ 12 was predictive of death (p = 0.011, 0.023, and 0.003, respectively).

Conclusions

Our results suggested that LUS can be used as a valuable tool for detecting COVID-19 pneumonia and determining high-risk hospitalized patients, helping to triage and stratify high-risk patients, which waives the need to undertake irradiating chest CT and reduces the burden of overworked CT department staff.