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Franchi R, Okoye C, Morelli V, Guarino D, Mazzarone T, Coppini G, Peta U, Rogani S, Fabbri A, Polini A, Monzani F. Utility of lung ultrasound in selecting older patients with hyperinflammatory phase in COVID-19 pneumonia. A monocentric, cross-sectional pilot study. JOURNAL OF GERONTOLOGY AND GERIATRICS 2022. [DOI: 10.36150/2499-6564-n554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Musolino AM, Ferro V, Supino MC, Boccuzzi E, Scateni S, Sinibaldi S, Cursi L, Schingo PMS, Reale A, Campana A, Raponi M, Villani A, Tomà P. One Year of Lung Ultrasound in Children with SARS-CoV-2 Admitted to a Tertiary Referral Children's Hospital: A Retrospective Study during 2020-2021. CHILDREN (BASEL, SWITZERLAND) 2022; 9:761. [PMID: 35626938 PMCID: PMC9139579 DOI: 10.3390/children9050761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/07/2022] [Accepted: 05/18/2022] [Indexed: 02/07/2023]
Abstract
During the COVID-19 pandemic, the lung ultrasound (LU) turned out to be a pivotal tool to study the lung involvement in the adult population, but the same was not well evaluated in children. We detected the LU patterns through an integrated approach with clinical−laboratory features in children hospitalized for COVID-19 in relation to the temporal trend of the Italian epidemic. We conducted a retrospective study which took place at a pediatric tertiary hospital from 15 March 2020 to 15 March 2021. We compared the characteristics of the initial phase of the first COVID-19 year—in the spring and summer (15 March−30 September 2020)—and those of the second phase—in the autumn and winter (1 October 2020−15 March 2021). Twenty-eight patients were studied both in the first and in the second phase of the first COVID-19 year. The disease severity score (DSS) was significantly greater in the second phase (p = 0.015). In the second phase of the first COVID-19 year, we detected a more significant occurrence of the following LU features than in the first phase: the irregular pleural line (85.71% vs. 60.71%; p = 0.035), the B-lines (89.29% vs. 60%; p = 0.003) and the several but non-coalescent B-lines (89.29% vs. 60%; p = 0.003). The LU score correlated significantly with the DSS, with a moderate relationship (r = 0.51, p < 0.001). The combined clinical, laboratory and ultrasound approaches might be essential in the evaluation of pulmonary involvement in children affected by COVID-19 during different periods of the pandemic.
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Affiliation(s)
- Anna Maria Musolino
- Pediatric Emergency, Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.M.M.); (M.C.S.); (E.B.); (S.S.); (A.R.)
| | - Valentina Ferro
- Pediatric Emergency, Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.M.M.); (M.C.S.); (E.B.); (S.S.); (A.R.)
| | - Maria Chiara Supino
- Pediatric Emergency, Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.M.M.); (M.C.S.); (E.B.); (S.S.); (A.R.)
| | - Elena Boccuzzi
- Pediatric Emergency, Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.M.M.); (M.C.S.); (E.B.); (S.S.); (A.R.)
| | - Simona Scateni
- Pediatric Emergency, Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.M.M.); (M.C.S.); (E.B.); (S.S.); (A.R.)
| | - Serena Sinibaldi
- Pediatric Unit, Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, 00050 Palidoro, Italy; (S.S.); (A.C.)
| | - Laura Cursi
- Immunology and Infectious Disease Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | | | - Antonino Reale
- Pediatric Emergency, Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.M.M.); (M.C.S.); (E.B.); (S.S.); (A.R.)
| | - Andrea Campana
- Pediatric Unit, Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, 00050 Palidoro, Italy; (S.S.); (A.C.)
| | - Massimiliano Raponi
- Medical Direction, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Alberto Villani
- General Pediatrics Unit, Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Paolo Tomà
- Department of Imaging, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (P.M.S.S.); (P.T.)
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Gil-Rodríguez J, Pérez de Rojas J, Aranda-Laserna P, Benavente-Fernández A, Martos-Ruiz M, Peregrina-Rivas JA, Guirao-Arrabal E. Ultrasound findings of lung ultrasonography in COVID-19: A systematic review. Eur J Radiol 2022; 148:110156. [PMID: 35078136 PMCID: PMC8783639 DOI: 10.1016/j.ejrad.2022.110156] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 02/06/2023]
Abstract
PURPOSE To identify the defining lung ultrasound (LUS) findings of COVID-19, and establish its association to the initial severity of the disease and prognostic outcomes. METHOD Systematic review was conducted according to the PRISMA guidelines. We queried PubMed, Embase, Web of Science, Cochrane Database and Scopus using the terms ((coronavirus) OR (covid-19) OR (sars AND cov AND 2) OR (2019-nCoV)) AND (("lung ultrasound") OR (LUS)), from 31st of December 2019 to 31st of January 2021. PCR-confirmed cases of SARS-CoV-2 infection, obtained from original studies with at least 10 participants 18 years old or older, were included. Risk of bias and applicability was evaluated with QUADAS-2. RESULTS We found 1333 articles, from which 66 articles were included, with a pooled population of 4687 patients. The most examined findings were at least 3 B-lines, confluent B-lines, subpleural consolidation, pleural effusion and bilateral or unilateral distribution. B-lines, its confluent presentation and pleural abnormalities are the most frequent findings. LUS score was higher in intensive care unit (ICU) patients and emergency department (ED), and it was associated with a higher risk of developing unfavorable outcomes (death, ICU admission or need for mechanical ventilation). LUS findings and/or the LUS score had a good negative predictive value in the diagnosis of COVID-19 compared to RT-PCR. CONCLUSIONS The most frequent ultrasound findings of COVID-19 are B-lines and pleural abnormalities. High LUS score is associated with developing unfavorable outcomes. The inclusion of pleural effusion in the LUS score and the standardisation of the imaging protocol in COVID-19 LUS remains to be defined.
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Affiliation(s)
- Jaime Gil-Rodríguez
- Internal Medicine Unit, San Cecilio University Hospital, Avenida del Conocimiento s/n, 18016 Granada, Spain,Corresponding author
| | - Javier Pérez de Rojas
- Preventive Medicine and Public Health Unit, San Cecilio University Hospital, Avenida del Conocimiento s/n, 18016 Granada, Spain
| | - Pablo Aranda-Laserna
- Internal Medicine Unit, San Cecilio University Hospital, Avenida del Conocimiento s/n, 18016 Granada, Spain
| | | | - Michel Martos-Ruiz
- Internal Medicine Unit, San Cecilio University Hospital, Avenida del Conocimiento s/n, 18016 Granada, Spain
| | | | - Emilio Guirao-Arrabal
- Infectious Diseases Unit, San Cecilio University Hospital, Avenida del Conocimiento s/n, 18016 Granada, Spain
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Lu W, Xie B, Ding Z. Edge Detection Algorithm-Based Lung Ultrasound in Evaluation of Efficacy of High-Flow Oxygen Therapy on Critical Lung Injury. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3604012. [PMID: 35126621 PMCID: PMC8808128 DOI: 10.1155/2022/3604012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/08/2021] [Indexed: 11/18/2022]
Abstract
The study focused on the therapeutic effects of high-flow oxygen therapy on patients with critical lung injury using edge detection-based ultrasound images. Firstly, the traditional Canny edge detection algorithm was improved, and the optimal threshold was obtained by optimizing the median filter and combining Otsu algorithm and threshold iteration method. Then, the optimized algorithm was compared with the traditional Canny edge detection algorithm and applied to process the lung ultrasound images of 120 cases of critical lung injury, to compare the efficacy of high-flow oxygen therapy and the traditional oxygen therapy. It was found that the peak signal-to-noise ratio (PSNR) (20.34~31.3), edge intensity value (17.89~27.34), and edge detection effect of the improved Canny algorithm were better than the traditional Canny algorithm (15.2~28.61, 9.44~18.56). The failure rate of extubation (4.1%), reintubation rate (0.8%), comfort (2.38 ± 0.15 points), dry humidity score (1.07 ± 0.21 points), antibiotic use (7.41 ± 0.74 days), and hospital stay (8.66 ± 1.02 days) in the experimental group were significantly lower than the corresponding indexes in the control group (11.7%, 5%, 4.25 ± 0.26 minutes, 4.94 ± 0.78 minutes, 19.29 ± 1.7 days, and 27.49 ± 2.22 days), and the difference was statistically significant (P < 0.05). In the experimental group, within 48 hours after extubation, the respiratory rate (RR), heart rate (HR), arterial partial pressure of carbon dioxide (PaCO2), and HCO3 - were significantly lower than those of the control group; and the values of transcutaneous oxygen saturation (SpO2), mean arterial pressure (MAP), arterial partial pressure of oxygen (PaO2), and pH were significantly higher than the control group, and the difference was statistically significant (P < 0.05). In conclusion, the algorithm in this study is superior to the traditional Canny algorithm, and the high-flow oxygen therapy can reduce the failure rate of extubation, strengthen patient comfort, improve the degree of gas humidification, stabilize the respiratory function and circulatory system, and shorten the time of antibiotic use and hospital stay.
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Affiliation(s)
- Wei Lu
- Department of Critical Care Medicine, General Hospital of the Yangtze River Shipping, Wuhan, 430010 Hubei, China
| | - Bin Xie
- Department of Respiratory Medicine, Yuebei People's Hospital, Shaoguan, 512025 Guangdong, China
| | - Zhaolei Ding
- Department of Respiratory Medicine, Weifang People's Hospital, Weifang, 261000 Shandong, China
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Wang Y, Zhang Y, He Q, Liao H, Luo J. Quantitative Analysis of Pleural Line and B-Lines in Lung Ultrasound Images for Severity Assessment of COVID-19 Pneumonia. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:73-83. [PMID: 34428140 PMCID: PMC8905613 DOI: 10.1109/tuffc.2021.3107598] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/21/2021] [Indexed: 06/12/2023]
Abstract
Specific patterns of lung ultrasound (LUS) images are used to assess the severity of coronavirus disease 2019 (COVID-19) pneumonia, while such assessment is mainly based on clinicians' qualitative and subjective observations. In this study, we quantitatively analyze the LUS images to assess the severity of COVID-19 pneumonia by characterizing the patterns related to the pleural line (PL) and B-lines (BLs). Twenty-seven patients with COVID-19 pneumonia, including 13 moderate cases, seven severe cases, and seven critical cases, are enrolled. Features related to the PL, including the thickness (TPL) and roughness of the PL (RPL), and the mean (MPLI) and standard deviation (SDPLI) of the PL intensities are extracted from the LUS images. Features related to the BLs, including the number (NBL), accumulated width (AWBL), attenuation coefficient (ACBL), and accumulated intensity (AIBL) of BLs, are also extracted. The correlations of these features with the disease severity are evaluated. The performances of the binary severe/non-severe classification are assessed for each feature and support vector machine (SVM) classifiers with various combinations of features as input. Several features, including the RPL, NBL, AWBL, and AIBL, show significant correlations with disease severity (all ). The classification performance is optimal using the SVM classifier using all the features as input (area under the receiver operating characteristic (ROC) curve = 0.96, sensitivity = 0.93, and specificity = 1). These findings demonstrate that the proposed method may be a promising tool for automatic grading diagnosis and follow-up of patients with COVID-19 pneumonia.
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Affiliation(s)
- Yuanyuan Wang
- Department of Biomedical EngineeringSchool of MedicineTsinghua UniversityBeijing100084China
| | - Yao Zhang
- Department of UltrasoundBeijing Ditan HospitalCapital Medical UniversityBeijing100015China
| | - Qiong He
- Department of Biomedical EngineeringSchool of MedicineTsinghua UniversityBeijing100084China
| | - Hongen Liao
- Department of Biomedical EngineeringSchool of MedicineTsinghua UniversityBeijing100084China
| | - Jianwen Luo
- Department of Biomedical EngineeringSchool of MedicineTsinghua UniversityBeijing100084China
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Vetrugno L, Mojoli F, Cortegiani A, Bignami EG, Ippolito M, Orso D, Corradi F, Cammarota G, Mongodi S, Boero E, Iacovazzo C, Vargas M, Poole D, Biasucci DG, Persona P, Bove T, Ball L, Chiumello D, Forfori F, de Robertis E, Pelosi P, Navalesi P, Giarratano A, Petrini F. Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care expert consensus statement on the use of lung ultrasound in critically ill patients with coronavirus disease 2019 (ITACO). JOURNAL OF ANESTHESIA, ANALGESIA AND CRITICAL CARE 2021. [PMCID: PMC8611396 DOI: 10.1186/s44158-021-00015-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background To produce statements based on the available evidence and an expert consensus (as members of the Lung Ultrasound Working Group of the Italian Society of Analgesia, Anesthesia, Resuscitation, and Intensive Care, SIAARTI) on the use of lung ultrasound for the management of patients with COVID-19 admitted to the intensive care unit. Methods A modified Delphi method was applied by a panel of anesthesiologists and intensive care physicians expert in the use of lung ultrasound in COVID-19 intensive critically ill patients to reach a consensus on ten clinical questions concerning the role of lung ultrasound in the following: COVID-19 diagnosis and monitoring (with and without invasive mechanical ventilation), positive end expiratory pressure titration, the use of prone position, the early diagnosis of pneumothorax- or ventilator-associated pneumonia, the process of weaning from invasive mechanical ventilation, and the need for radiologic chest imaging. Results A total of 20 statements were produced by the panel. Agreement was reached on 18 out of 20 statements (scoring 7–9; “appropriate”) in the first round of voting, while 2 statements required a second round for agreement to be reached. At the end of the two Delphi rounds, the median score for the 20 statements was 8.5 [IQR 8.9], and the agreement percentage was 100%. Conclusion The Lung Ultrasound Working Group of the Italian Society of Analgesia, Anesthesia, Resuscitation, and Intensive Care produced 20 consensus statements on the use of lung ultrasound in COVID-19 patients admitted to the ICU. This expert consensus strongly suggests integrating lung ultrasound findings in the clinical management of critically ill COVID-19 patients. Supplementary Information The online version contains supplementary material available at 10.1186/s44158-021-00015-6.
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7
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Pal A, Ali A, Young TR, Oostenbrink J, Prabhakar A, Prabhakar A, Deacon N, Arnold A, Eltayeb A, Yap C, Young DM, Tang A, Lakshmanan S, Lim YY, Pokarowski M, Kakodkar P. Comprehensive literature review on the radiographic findings, imaging modalities, and the role of radiology in the COVID-19 pandemic. World J Radiol 2021; 13:258-282. [PMID: 34630913 PMCID: PMC8473437 DOI: 10.4329/wjr.v13.i9.258] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/28/2021] [Accepted: 08/04/2021] [Indexed: 02/06/2023] Open
Abstract
Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, over 103214008 cases have been reported, with more than 2231158 deaths as of January 31, 2021. Although the gold standard for diagnosis of this disease remains the reverse-transcription polymerase chain reaction of nasopharyngeal and oropharyngeal swabs, its false-negative rates have ignited the use of medical imaging as an important adjunct or alternative. Medical imaging assists in identifying the pathogenesis, the degree of pulmonary damage, and the characteristic features in each imaging modality. This literature review collates the characteristic radiographic findings of COVID-19 in various imaging modalities while keeping the preliminary focus on chest radiography, computed tomography (CT), and ultrasound scans. Given the higher sensitivity and greater proficiency in detecting characteristic findings during the early stages, CT scans are more reliable in diagnosis and serve as a practical method in following up the disease time course. As research rapidly expands, we have emphasized the CO-RADS classification system as a tool to aid in communicating the likelihood of COVID-19 suspicion among healthcare workers. Additionally, the utilization of other scoring systems such as MuLBSTA, Radiological Assessment of Lung Edema, and Brixia in this pandemic are reviewed as they integrate the radiographic findings into an objective scoring system to risk stratify the patients and predict the severity of disease. Furthermore, current progress in the utilization of artificial intelligence via radiomics is evaluated. Lastly, the lesson from the first wave and preparation for the second wave from the point of view of radiology are summarized.
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Affiliation(s)
- Aman Pal
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Galway, Ireland
| | - Abulhassan Ali
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Galway, Ireland
| | - Timothy R Young
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Galway, Ireland
| | - Juan Oostenbrink
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Galway, Ireland
| | - Akul Prabhakar
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Galway, Ireland
| | - Amogh Prabhakar
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Galway, Ireland
| | - Nina Deacon
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Galway, Ireland
| | - Amar Arnold
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Galway, Ireland
| | - Ahmed Eltayeb
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Galway, Ireland
| | - Charles Yap
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Galway, Ireland
| | - David M Young
- Department of Computer Science, Yale University, New Haven, CO 06520, United States
| | - Alan Tang
- Department of Health Science, Duke University, Durham, NC 27708, United States
| | - Subramanian Lakshmanan
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Galway, Ireland
| | - Ying Yi Lim
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Galway, Ireland
| | - Martha Pokarowski
- The Hospital for Sick Kids, University of Toronto, Toronto M5S, Ontario, Canada
| | - Pramath Kakodkar
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, Galway, Ireland
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Tana C, Ricci F, Coppola MG, Mantini C, Lauretani F, Campanozzi D, Renda G, Gallina S, Lugará M, Cipollone F, Giamberardino MA, Mucci L. Prognostic Significance of Chest Imaging by LUS and CT in COVID-19 Inpatients: The ECOVID Multicenter Study. Respiration 2021; 101:122-131. [PMID: 34515247 PMCID: PMC8450833 DOI: 10.1159/000518516] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/08/2021] [Indexed: 12/21/2022] Open
Abstract
Background Point-of-care lung ultrasound (LUS) score is a semiquantitative score of lung damage severity. High-resolution computed tomography (HRCT) is the gold standard method to evaluate the severity of lung involvement from the novel coronavirus disease (COVID-19). Few studies have investigated the clinical significance of LUS and HRCT scores in patients with COVID-19. Therefore, the aim of this study was to evaluate the prognostic yield of LUS and of HRCT in COVID-19 patients. Methods We carried out a multicenter, retrospective study aimed at evaluating the prognostic yield of LUS and HRCT by exploring the survival curve of COVID-19 inpatients. LUS and chest CT scores were calculated retrospectively by 2 radiologists with >10 years of experience in chest imaging, and the decisions were reached in consensus. LUS score was calculated on the basis of the presence or not of pleural line abnormalities, B-lines, and lung consolidations. The total score (range 0–36) was obtained from the sum of the highest scores obtained in each region. CT score was calculated for each of the 5 lobes considering the anatomical extension according to the percentage parenchymal involvement. The resulting overall global semiquantitative CT score was the sum of each single lobar score and ranged from 0 (no involvement) to 25 (maximum involvement). Results One hundred fifty-three COVID-19 inpatients (mean age 65 ± 15 years; 65% M), including 23 (15%) in-hospital deaths for any cause over a mean follow-up of 14 days were included. Mean LUS and CT scores were 19 ± 12 and 10 ± 7, respectively. A strong positive linear correlation between LUS and CT scores (Pearson correlation r = 0.754; R<sup>2</sup> = 0.568; p < 0.001) was observed. By ROC curve analysis, the optimal cut-point for mortality prediction was 20 for LUS score and 4.5 for chest CT score. According to Kaplan-Meier survival analysis, in-hospital mortality significantly increased among COVID-19 patients presenting with an LUS score ≥20 (log-rank 0.003; HR 9.87, 95% CI: 2.22–43.83) or a chest CT score ≥4.5 (HR 4.34, 95% CI: 0.97–19.41). At multivariate Cox regression analysis, LUS score was the sole independent predictor of in-hospital mortality yielding an adjusted HR of 7.42 (95% CI: 1.59–34.5). Conclusion LUS score is useful to stratify the risk in COVID-19 patients, predicting those that are at high risk of mortality.
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Affiliation(s)
- Claudio Tana
- COVID-19 Medicine Unit and Geriatrics Clinic, SS Annunziata Hospital of Chieti, Chieti, Italy
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Department of Clinical Sciences, Lund University, Malmö, Sweden.,Casa di Cura Villa Serena, Città Sant'Angelo, Pescara, Italy
| | | | - Cesare Mantini
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Fulvio Lauretani
- Department of Medicine and Surgery, University of Parma, Parma, Italy.,Cognitive and Motor Center, Geriatric-Rehabilitation Department of Parma, University-Hospital of Parma, Parma, Italy
| | - Daniele Campanozzi
- Internal Medicine and Covid-19 Unit, Pesaro Hospital, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Giulia Renda
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Marina Lugará
- COVID-19 Medicine Unit, Ospedale del Mare, Napoli, Italy
| | - Francesco Cipollone
- COVID-19 Medicine Unit and Medical Clinic, SS Annunziata Hospital of Chieti, Department of Medicine and Science of Aging, G D'Annunzio University of Chieti, Chieti, Italy
| | - Maria Adele Giamberardino
- COVID-19 Medicine Unit and Geriatrics Clinic, SS Annunziata Hospital of Chieti, Department of Medicine and Science of Aging, and CAST, G D'Annunzio University of Chieti, Chieti, Italy
| | - Luciano Mucci
- Internal Medicine and Covid-19 Unit, Pesaro Hospital, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
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9
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Barros B, Lacerda P, Albuquerque C, Conci A. Pulmonary COVID-19: Learning Spatiotemporal Features Combining CNN and LSTM Networks for Lung Ultrasound Video Classification. SENSORS (BASEL, SWITZERLAND) 2021; 21:5486. [PMID: 34450928 PMCID: PMC8401701 DOI: 10.3390/s21165486] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 12/18/2022]
Abstract
Deep Learning is a very active and important area for building Computer-Aided Diagnosis (CAD) applications. This work aims to present a hybrid model to classify lung ultrasound (LUS) videos captured by convex transducers to diagnose COVID-19. A Convolutional Neural Network (CNN) performed the extraction of spatial features, and the temporal dependence was learned using a Long Short-Term Memory (LSTM). Different types of convolutional architectures were used for feature extraction. The hybrid model (CNN-LSTM) hyperparameters were optimized using the Optuna framework. The best hybrid model was composed of an Xception pre-trained on ImageNet and an LSTM containing 512 units, configured with a dropout rate of 0.4, two fully connected layers containing 1024 neurons each, and a sequence of 20 frames in the input layer (20×2018). The model presented an average accuracy of 93% and sensitivity of 97% for COVID-19, outperforming models based purely on spatial approaches. Furthermore, feature extraction using transfer learning with models pre-trained on ImageNet provided comparable results to models pre-trained on LUS images. The results corroborate with other studies showing that this model for LUS classification can be an important tool in the fight against COVID-19 and other lung diseases.
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Affiliation(s)
- Bruno Barros
- Institute of Computing, Campus Praia Vermelha, Fluminense Federal University, Niterói 24.210-346, Brazil; (P.L.); (C.A.); (A.C.)
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10
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Sideris GA, Nikolakea M, Karanikola AE, Konstantinopoulou S, Giannis D, Modahl L. Imaging in the COVID-19 era: Lessons learned during a pandemic. World J Radiol 2021. [DOI: 10.4329/wjr.v13.i6.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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11
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Sideris GA, Nikolakea M, Karanikola AE, Konstantinopoulou S, Giannis D, Modahl L. Imaging in the COVID-19 era: Lessons learned during a pandemic. World J Radiol 2021; 13:192-222. [PMID: 34249239 PMCID: PMC8245753 DOI: 10.4329/wjr.v13.i6.192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/02/2021] [Accepted: 06/15/2021] [Indexed: 02/07/2023] Open
Abstract
The first year of the coronavirus disease 2019 (COVID-19) pandemic has been a year of unprecedented changes, scientific breakthroughs, and controversies. The radiology community has not been spared from the challenges imposed on global healthcare systems. Radiology has played a crucial part in tackling this pandemic, either by demonstrating the manifestations of the virus and guiding patient management, or by safely handling the patients and mitigating transmission within the hospital. Major modifications involving all aspects of daily radiology practice have occurred as a result of the pandemic, including workflow alterations, volume reductions, and strict infection control strategies. Despite the ongoing challenges, considerable knowledge has been gained that will guide future innovations. The aim of this review is to provide the latest evidence on the role of imaging in the diagnosis of the multifaceted manifestations of COVID-19, and to discuss the implications of the pandemic on radiology departments globally, including infection control strategies and delays in cancer screening. Lastly, the promising contribution of artificial intelligence in the COVID-19 pandemic is explored.
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Affiliation(s)
- Georgios Antonios Sideris
- Department of Radiology, University of Massachusetts Medical School, Baystate Medical Center, Springfield, MA 01199, United States
- Radiology Working Group, Society of Junior Doctors, Athens 11527, Greece
| | - Melina Nikolakea
- Radiology Working Group, Society of Junior Doctors, Athens 11527, Greece
| | | | - Sofia Konstantinopoulou
- Division of Pulmonary Medicine, Department of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi W13-01, United Arab Emirates
| | - Dimitrios Giannis
- Institute of Health Innovations and Outcomes Research, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030, United States
| | - Lucy Modahl
- Department of Radiology, University of Massachusetts Medical School, Baystate Medical Center, Springfield, MA 01199, United States
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Association of Lung Ultrasound Score with Mortality and Severity of COVID-19: A Meta-Analysis and Trial Sequential Analysis. Int J Infect Dis 2021; 108:603-609. [PMID: 34146693 PMCID: PMC8266421 DOI: 10.1016/j.ijid.2021.06.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/31/2021] [Accepted: 06/12/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic has rapidly spread all over the world. Lung ultrasound (LUS) has emerged as a useful tool for diagnosing many respiratory diseases. The prognostic role of LUS in COVID-19 patients has not yet been established. METHODS Several databases were searched on 09 April 2021. The difference in LUS score between the death and survival groups, and the relationship between LUS score and COVID-19 severity were both assessed. RESULTS The LUS score was significantly higher in the death group compared with the survival group (weighted mean difference (WMD) = 8.21, 95% CI: 4.74-11.67, P < 0.001), which was confirmed by trial sequential analysis. Those with mild/moderate, severe and critical COVID-19 had a progressively higher LUS score (critical vs. severe: WMD = 8.78, 95% CI: 4.17-13.38; P < 0.001; critical vs. mild/moderate/severe: WMD = 10.00, 95% CI: 6.83-13.17, P < 0.001; severe vs. moderate: WMD = 5.96, 95% CI: 3.48-8.44, P < 0.001; severe vs. mild/moderate: WMD = 7.31, 95% CI: 4.45-10.17, P < 0.001). CONCLUSIONS The LUS score was associated with mortality and severity of COVID-19. The LUS score might be a risk stratification tool for COVID-19 patients.
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Karp J, Burke K, Daubaras SM, McDermott C. The role of PoCUS in the assessment of COVID-19 patients. J Ultrasound 2021; 25:207-215. [PMID: 33870480 PMCID: PMC8053566 DOI: 10.1007/s40477-021-00586-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 04/08/2021] [Indexed: 01/14/2023] Open
Abstract
The Coronavirus disease 19 (COVID-19) pandemic has increased the burden of stress on the global healthcare system in 2020. Point of care ultrasound (PoCUS) is used effectively in the management of pulmonary, cardiac and vascular pathologies. POCUS is the use of traditional ultrasound imaging techniques in a focused binary manner to answer a specific set of clinical questions. This is an imaging technique that delivers no radiation, is inexpensive, ultraportable and provides results instantaneously to the physician operator at the bedside. In regard to the pandemic, PoCUS has played a significant adjunctive role in the diagnosis and management of co-morbidities associated with COVID-19. PoCUS also offers an alternative method to image obstetric patients and the pediatric population safely in accordance with the ALARA principle. Finally, there have been numerous PoCUS protocols describing the effective use of this technology during the COVID-19 pandemic.
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Affiliation(s)
- John Karp
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - Karina Burke
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Cian McDermott
- Emergency Department and Emergency Ultrasound Education, Mater University Hospital, Dublin, Ireland
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14
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Mafort TT, Rufino R, da Costa CH, da Cal MS, Monnerat LB, Litrento PF, Parra LLZ, Marinho ADSEDS, Lopes AJ. One-month outcomes of patients with SARS-CoV-2 infection and their relationships with lung ultrasound signs. Ultrasound J 2021; 13:19. [PMID: 33835273 PMCID: PMC8033556 DOI: 10.1186/s13089-021-00223-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/30/2021] [Indexed: 12/13/2022] Open
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.
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Affiliation(s)
- Thiago Thomaz Mafort
- 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.,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
| | - Rogério Rufino
- 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.,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
| | - Claudia Henrique da Costa
- 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.,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
| | - Mariana Soares da Cal
- 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
| | - Laura Braga Monnerat
- 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
| | - Patrícia Frascari Litrento
- 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
| | - Laura Lizeth Zuluaga Parra
- 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
| | - Arthur de Sá Earp de Souza Marinho
- 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
| | - Agnaldo José Lopes
- 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. .,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. .,Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rua Dona Isabel, 94, Bonsucesso, Rio de Janeiro, 21032-060, Brazil.
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Use of the lung ultrasound score in monitoring COVID-19 patients: it's time for a reappraisal. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2021; 25:47. [PMID: 33536024 PMCID: PMC7856600 DOI: 10.1186/s13054-021-03483-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 01/27/2021] [Indexed: 11/10/2022]
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