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Sartini S, Ferrari L, Cutuli O, Castellani L, Cristina ML, Arboscello E, Sartini M. The Role of POCUS to Face COVID-19: A Narrative Review. J Clin Med 2024; 13:2756. [PMID: 38792298 PMCID: PMC11121862 DOI: 10.3390/jcm13102756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
COVID-19 has been a challenging outbreak to face, with millions of deaths among the globe. Acute respiratory failure due to interstitial pneumonia was the leading cause of death other than prothrombotic activation and complications. Lung ultrasound (LUS) and point-of-care ultrasound (POCUS) are widely used not only to triage, to identify, and to monitor lungs involvement but also to assess hemodynamic status and thrombotic and hemorrhagic complications, mainly in critically ill patients. POCUS has gained growing consideration due to its bedside utilization, reliability, and reproducibility even in emergency settings especially in unstable patients. In this narrative review, we aim to describe LUS and POCUS utilization in COVID-19 infection based on the literature found on this topic. We reported the LUS patterns of COVID-19 pulmonary infection, the diagnostic accuracy with respect to CT lung scan, its prognostic value, the variety of scores and protocols proposed, and the utilization of POCUS to investigate the extra-lung complications.
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Affiliation(s)
- Stefano Sartini
- Emergency Medicine Department, IRCCS Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy; (O.C.); (L.C.); (E.A.)
| | - Lorenzo Ferrari
- Emergency Medicine Post-Graduate School, University of Genoa, Via Balbi 5, 16126 Genoa, Italy;
| | - Ombretta Cutuli
- Emergency Medicine Department, IRCCS Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy; (O.C.); (L.C.); (E.A.)
| | - Luca Castellani
- Emergency Medicine Department, IRCCS Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy; (O.C.); (L.C.); (E.A.)
| | - Maria Luisa Cristina
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy;
- Hospital Hygiene, E.O. Ospedali Galliera, Via Alessandro Volta 8, 16128 Genoa, Italy
| | - Eleonora Arboscello
- Emergency Medicine Department, IRCCS Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy; (O.C.); (L.C.); (E.A.)
| | - Marina Sartini
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy;
- Hospital Hygiene, E.O. Ospedali Galliera, Via Alessandro Volta 8, 16128 Genoa, Italy
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Chen J, Shen M, Hou S, Duan X, Yang M, Cao Y, Qin W, Niu Q, Li Q, Zhang Y, Wang Y. Intelligent interpretation of four lung ultrasonographic features with split attention based deep learning model. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ma HR, Deng BY, Liu J, Jiang P, Xu YL, Song XY, Li J, Huang LH, Bao LY, Shan RY, Fu W. Lung ultrasound to diagnose infectious pneumonia of newborns: A prospective multicenter study. Pediatr Pulmonol 2023; 58:122-129. [PMID: 36169007 DOI: 10.1002/ppul.26168] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/02/2022] [Accepted: 09/14/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Whether lung ultrasound (LUS) can be used for pathogenic diagnosis remains controversial. This study was conducted to clarify whether ultrasound has diagnostic value for etiology. METHODS A total of 135 neonatal pneumonia patients with an identified pathogen were enrolled from the newborn intensive care units of 10 tertiary hospitals in China. The study ran from November 2020 to December 2021. The infants were divided into various groups according to pathogens, time of infection, gestational age, and disease severity. The distribution of pleural line abnormalities, B-line signs, and pulmonary consolidation, as well as the incidence of air bronchogram and pleural effusion based on LUS, were compared between these groups. RESULTS There were significant differences in pulmonary consolidation. The sensitivity and specificity of the diagnosis of severe pneumonia based on the extent of pulmonary consolidation were 83.3% and 85.2%, respectively. The area under the receiver operating characteristic curve for the identification of mild or severe pneumonia based on the distribution of pulmonary consolidation was 0.776. CONCLUSION LUS has good performance in diagnosing and differentiating the severity of neonatal pneumonia but cannot be used for pathogenic identification in the early stages of pneumonia.
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Affiliation(s)
- Hai-Ran Ma
- Department of Paediatrics, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Neonatology and Neonatal Intensive Care Unit, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,Department of Neonatology and Neonatal Intensive Care Unit, Huizhou Central People's Hospital, Huizhou, China
| | - Bi-Ying Deng
- Department of Neonatal Intensive Care Unit, Dongguan Children's Hospital, Guangdong Medical University, Dongguan, China
| | - Jing Liu
- Department of Paediatrics, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Neonatology and Neonatal Intensive Care Unit, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Peng Jiang
- Department of Paediatrics, Liaocheng People's Hospital, Liaocheng, China
| | - Yan-Lei Xu
- Department of Neonatology and Neonatal Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiu-Yun Song
- Children's hospital of Shanxi (Women Health Center of Shanxi), Taiyuan, China
| | - Jie Li
- Department of Neonatology, Maternity and Child Health Care of Zaozhuang, Zaozhuang, China
| | - Li-Han Huang
- Department of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen university, Xiamen key laboratory of perinatal-neonatal infection, Xiamen, China
| | - Ling-Yun Bao
- Department of Neonatology, Kunming Children's Hospital, Kunming, China
| | - Rui-Yan Shan
- Department of Pediatrics, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Wei Fu
- Department of Neonatology and Neonatal Intensive Care Unit, Beijing Chaoyang District Maternal and Child Healthcare Hospital, Beijing, China
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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: 21] [Impact Index Per Article: 7.0] [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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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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