# ent

id: cord-005573-mryrl1s1
type: DISEASE
entity:
  critically ill Lung sliding Neonatal lung ultrasound exam guidelines Lung ultrasound decreased radiation exposure in preterm infants


id: cord-013065-oj0wsstz
type: GGP
entity:
  Cronbach s alpha A p 0 05 will be considered significant The statistical program SPPS 20 0 will be used Nowadays care standards are focused on the quality of care As the World Health Organization stipulates the patient must be diagnosed and treated correctly This clinical trial is focused on improving the quality of care for paediatric patients with suspected bacterial


id: cord-292341-uo54ghf3
type: ORG
entity:
  the University Hospital of Padova Division of Infectious and Tropical Diseases Respiratory Disease Unit


id: cord-300013-6m1f4q5r
type: ORG
entity:
  the European Society of Clinical Microbiology and Infectious Diseases Thoracic Ultrasound Technique Applications and Interpretation International


id: cord-334495-7y1la856
type: ORG
entity:
  non obstructive coronary arteries Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID 19


id: cord-341627-21m8rdhy
type: CELL_LINE
entity:
  Coronavirus Disease 19 COVID 19 Relationship to Duration of Infection Ultrasound patterns of pulmonary edema Thoracic ultrasonography a narrative review The comet tail


id: cord-341627-21m8rdhy
type: LAW
entity:
  the COVID 19 Pandemic Feasibility of Paramedic Performed Prehospital Lung Ultrasound in Medical Patients with Respiratory Distress International


id: cord-344117-lr6roxej
type: WORK_OF_ART
entity:
  A Preliminary Study on the Ultrasonic Manifestations of Peripulmonary Lesions of Non Critical Novel Coronavirus Pneumonia COVID 19


id: cord-349641-4g4nue5s
type: ORG
entity:
  Re Proposal for International Standardization of the Use of Lung Ultrasound for Patients With COVID 19


id: cord-347631-78h9w2ty
type: DNA
entity:
  SAGE Open Med Case Rep DOI 10 1177 2050313x20958915 sha b306d421dacb170bb3d27f215b3ef0e2679899e3 doc_id 347631


id: cord-015352-2d02eq3y
type: PROTEIN
entity:
  N Colavolpe A Aschero B Bourliere Najean C Roman F Khachab H Pico M Kheiri G Gorincour C Desvignes P Petit Marseille FR


id: cord-015352-2d02eq3y
type: PROTEIN
entity:
  Help E Kovacs 1 N Pinter 2 G Balázs 1 A Machovitsch 1 A Arany 1 Z Liptai 1 L Fonyad 1 P Benke 1 1 Budapest HU 2 Amherst US Objective


id: cord-015352-2d02eq3y
type: GGP
entity:
  CMD p 0 11 Linear hierarchical regressions controlling the age did not show a significant relation between ADC and cortical or renal transit times p 0 68 but lower FA values


id: cord-015352-2d02eq3y
type: DISEASE
entity:
  pulmonary artery pulmonary sequestration systemic arterialization of lung absence of inferior vena cava


id: cord-015352-2d02eq3y
type: DISEASE
entity:
  congenital pulmonary airway malformation CPAM 1 hemithorax pulmonary sequestration 1 hemithorax partial pneumothorax


# bib

id: cord-000308-cxr1ul7q
author: Cianchi, Giovanni
date: 2011-01-11
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3022902/
doi: 10.1186/1471-2466-11-2
title:
  Ventilatory and ECMO treatment of H1N1-induced severe respiratory failure: results of an Italian referral ECMO center

abstract:
  BACKGROUND: Since the first outbreak of a respiratory illness caused by H1N1 virus in Mexico, several reports have described the need of intensive care or extracorporeal membrane oxygenation (ECMO) assistance in young and often healthy patients. Here we describe our experience in H1N1-induced ARDS using both ventilation strategy and ECMO assistance. METHODS: Following Italian Ministry of Health instructions, an Emergency Service was established at the Careggi Teaching Hospital (Florence, Italy) for the novel pandemic influenza. From Sept 09 to Jan 10, all patients admitted to our Intensive Care Unit (ICU) of the Emergency Department with ARDS due to H1N1 infection were studied. All ECMO treatments were veno-venous. H1N1 infection was confirmed by PCR assayed on pharyngeal swab, subglottic aspiration and bronchoalveolar lavage. Lung pathology was evaluated daily by lung ultrasound (LUS) examination. RESULTS: A total of 12 patients were studied: 7 underwent ECMO treatment, and 5 responded to protective mechanical ventilation. Two patients had co-infection by Legionella Pneumophila. One woman was pregnant. In our series, PCR from bronchoalveolar lavage had a 100% sensitivity compared to 75% from pharyngeal swab samples. The routine use of LUS limited the number of chest X-ray examinations and decreased transportation to radiology for CT-scan, increasing patient safety and avoiding the transitory disconnection from ventilator. No major complications occurred during ECMO treatments. In three cases, bleeding from vascular access sites due to heparin infusion required blood transfusions. Overall mortality rate was 8.3%. CONCLUSIONS: In our experience, early ECMO assistance resulted safe and feasible, considering the life threatening condition, in H1N1-induced ARDS. Lung ultrasound is an effective mean for daily assessment of ARDS patients.


id: cord-005573-mryrl1s1
author: Raimondi, Francesco
date: 2018-07-20
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7094915/
doi: 10.1038/s41390-018-0114-9
title:
  Point-of-care lung ultrasound in neonatology: classification into descriptive and functional applications

abstract:
  Lung ultrasound (LUS) is the latest amongst imaging techniques: it is a radiation-free, inexpensive, point-of-care tool that the clinician can use at the bedside. This review summarises the rapidly growing scientific evidence on LUS in neonatology, dividing it into descriptive and functional applications. We report the description of the main ultrasound features of neonatal respiratory disorders and functional applications of LUS aiming to help a clinical decision (such as surfactant administration, chest drainage etc). Amongst the functional applications, we propose SAFE (Sonographic Algorithm for liFe threatening Emergencies) as a standardised protocol for emergency functional LUS in critical neonates. SAFE has been funded by a specific grant issued by the European Society for Paediatric Research. Future potential development of LUS in neonatology might be linked to its quantitative evaluation: we also discuss available data and research directions using computer-aided diagnostic techniques. Finally, tools and opportunities to teach LUS and expand the research network are briefly presented.


id: cord-010871-qyqs293j
author: Sachin, Sasidharan
date: 2020-01-11
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7222928/
doi: 10.1007/s10877-020-00460-8
title:
  Ultrasonographic evaluation of lung and heart in predicting successful weaning in mechanically ventilated neurosurgical patients

abstract:
  In critically ill neurosurgical patients, delayed and premature extubation increases the risk of morbidity and mortality. Assessment of critically ill patients before and during spontaneous breathing trial (SBT) is crucial in predicting weaning failure. We explored the trend of changes with integrated lung and cardiac ultrasonography in predicting success of weaning in neurosurgical patients. Lung ultrasound and cardiac ultrasound was performed before and after 30 min and 120 min of SBT. Lung ultrasound score (LUS, range 0–36) was calculated using a predefined method of assessment of six chest regions on either side. The left ventricular function was evaluated by measuring fractional area change. The maximum velocities of mitral inflow E and A waves (E/A), deceleration time of E wave (DTE) and tissue doppler based E′ wave at lateral annulus to calculate E/E′, were measured to assess left ventricular filling pressure. Twenty seven patients underwent SBT, among these 22 had success and five had failure of SBT. The SBT failure group had higher baseline LUS and progressively higher LUS during SBT compared to the success group, suggesting significant lung de-recruitment. There was significant increase in the LV filling pressure (increase E/A and E/E′, decrease in DTE) after 30 and 120 min of SBT in failure group compared to the success group. Point of care lung and cardiac ultrasonography may be useful in detecting cardiopulmonary changes induced by SBT. Higher lung aeration loss and LV filling pressure were observed with SBT failure group.


id: cord-013065-oj0wsstz
author: Rodríguez-Fanjul, Javier
date: 2020-10-08
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7543673/
doi: 10.1186/s12931-020-01476-z
title:
  Procalcitonin and lung ultrasound algorithm to diagnose severe pneumonia in critical paediatric patients (PROLUSP study). A randomised clinical trial

abstract:
  BACKGROUND: Lung ultrasound (LUS) in combination with a biomarker has not yet been studied. We propose a clinical trial where the primary aims are: 1. To assess whether an algorithm with LUS and procalcitonin (PCT) may be useful for diagnosing bacterial pneumonia; 2. To analyse the sensitivity and specificity of LUS vs chest X-ray (CXR). METHODS/DESIGN: A 3-year clinical trial. Inclusion criteria: children younger than 18 years old with suspected pneumonia in a Paediatric Intensive Care Unit. Patients will be randomised into two groups: Experimental Group: LUS will be performed as first lung image. Control Group: CXR will be performed as first pulmonary image. Patients will be classified according to the image and the PCT: a) PCT < 1 ng/mL and LUS/CXR are not suggestive of bacterial pneumonia (BN), no antibiotic will be prescribed; b) LUS/CXR are suggestive of BN, regardless of the PCT, antibiotic therapy is recommended; c) LUS/CXR is not suggestive of BN and PCT > 1 ng/mL, antibiotic therapy is recommended. CONCLUSION: This algorithm will help us to diagnose bacterial pneumonia and to prescribe the correct antibiotic treatment. A reduction of antibiotics per patient, of the treatment length, and of the exposure to ionizing radiation and in costs is expected. TRIAL REGISTRATION: NCT04217980.


id: cord-015352-2d02eq3y
title: ESPR 2017
author: nan
date: 2017-04-26
txt: ./txt/cord-015352-2d02eq3y.txt
cache: ./cache/cord-015352-2d02eq3y.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103096/
doi: 10.1007/s00247-017-3820-2
abstract: nan
summary:
  Lapierre; Montreal/CA Summary: Objectives: To review the classification of visceroatrial situs To describe the associated cardiac and non-cardiac anomalies To illustrate typical findings in fetuses, neonates and children To discuss the surgical consideration and the long-term follow-up in these patients Abstract: By definition, the type of situs is determined by the relationship between the atria and the adjacent organs. As is often the case, radiology in JIA is all about: knowing your clinicians (i.e. the pretest likelihood for disease) being technically eloquent (e.g. using high-resolution US probes, not delaying post-contrast MRI acquisitions) knowing what is normal (e.g. normal undulations in the articular surface, focal bone marrow signal variation) not being dogmatic about individual observations or measurements interpreting your findings in a clinical context The lecture will demonstrate similarities and differences among joints and modalities in children with variable-severity JIA.


id: cord-029675-7lmqp4jd
author: Rodriguez-Fanjul, Javier
date: 2020-07-24
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378405/
doi: 10.1007/s00431-020-03744-y
title:
  Early surfactant replacement guided by lung ultrasound in preterm newborns with RDS: the ULTRASURF randomised controlled trial

abstract:
  This study aimed to investigate whether using lung ultrasound (LUS) scores in premature newborns with respiratory distress syndrome (RDS) allows for earlier surfactant therapy (within the first 3 h of life) than using FiO(2) criteria. This was a randomised, non-blinded clinical trial conducted in a neonatal intensive care unit. The inclusion criteria were newborns with a gestational age of ≤ 32 weeks and RDS. Patients meeting the inclusion criteria were randomly assigned to two groups: the ultrasound group, administered surfactant based on LUS score and/or FiO(2) threshold, and the control group, guided by FiO(2) only. Fifty-six patients were included. The ultrasound group received surfactant earlier (1 h of life vs. 6 h, p < 0.001), with lower FiO(2) (25% vs. 30%, p = 0.016) and lower CO(2) (48 vs. 54, p = 0.011). After surfactant treatment, newborns in the ultrasound group presented a greater SpO(2) (p = 0.001) and SpO(2)/FiO(2) ratio (p = 0.012). Conclusions: LUS score allowed an earlier surfactant therapy, reduced oxygen exposure early in life and a better oxygenation after the treatment. This early surfactant replacement may lead to reduced oxygen exposure.


id: cord-252784-wfsq0u9o
author: Favot, Mark
date: 2020-07-31
url: https://doi.org/10.1097/cce.0000000000000176
doi: 10.1097/cce.0000000000000176
title:
  Point-of-Care Lung Ultrasound for Detecting Severe Presentations of Coronavirus Disease 2019 in the Emergency Department: A Retrospective Analysis

abstract:
  OBJECTIVES: Analyze the diagnostic test characteristics of point-of-care lung ultrasound for patients suspected to have novel coronavirus disease 2019. DESIGN: Retrospective cohort. SETTING: Two emergency departments in Detroit, Michigan, United States, during a local coronavirus disease 2019 outbreak (March 2020 to April 2020). PATIENTS: Emergency department patients receiving lung ultrasound for clinical suspicion of coronavirus disease 2019 during the study period. INTERVENTIONS: None, observational analysis only. MEASUREMENTS AND MAIN RESULTS: By a reference standard of serial reverse transcriptase-polymerase chain reactions, 42 patients were coronavirus disease 2019 positive, 16 negative, and eight untested (test results lost, died prior to testing, and/or did not meet hospital guidelines for rationing of reverse transcriptase-polymerase chain reaction tests). Thirty-three percent, 44%, 38%, and 17% had mortality, ICU admission, intubation, and venous or arterial thromboembolism, respectively. Receiver operating characteristics, area under the curve, sensitivity, and specificity with 95% CIs were calculated for five lung ultrasound patterns coded by a blinded reviewer and chest radiograph. Chest radiograph had area under the curve = 0.66 (95% CI, 0.54–0.79), 74% sensitivity (95% CI, 48–93%), and 53% specificity (95% CI, 32–75%). Two lung ultrasound patterns had a statistically significant area under the curve: symmetric bilateral pulmonary edema (area under the curve, 0.57; 95% CI, 0.50–0.64), and a nondependent bilateral pulmonary edema pattern (edema in superior lung ≥ inferior lung and no pleural effusion; area under the curve, 0.73; 95% CI, 0.68–0.90). Chest radiograph plus the nondependent bilateral pulmonary edema pattern showed a statistically improved area under the curve (0.80; 95% CI, 0.68–0.90) compared to either alone, but at the ideal cutoff had sensitivity and specificity equivalent to nondependent bilateral pulmonary edema only (69% and 77%, respectively). The strongest combination of clinical, chest radiograph, and lung ultrasound factors for diagnosis was nondependent bilateral pulmonary edema pattern with temperature and oxygen saturation (area under the curve, 0.86; 95% CI, 0.76–0.94; sensitivity = 77% [58–93%]; specificity = 76% [53–94%] at the ideal cutoff), which was superior to chest radiograph alone. CONCLUSIONS: Lung ultrasound diagnosed severe presentations of coronavirus disease 2019 with similar sensitivity to chest radiograph, CT, and reverse transcriptase-polymerase chain reaction (on first testing) and improved specificity compared to chest radiograph. Diagnostically useful lung ultrasound patterns differed from those hypothesized by previous, nonanalytical, reports (case series and expert opinion), and should be evaluated in a rigorous prospective study.


id: cord-253572-9qixiew8
author: Bennett, David
date: 2020-09-21
url: https://doi.org/10.1016/j.ultrasmedbio.2020.09.014
doi: 10.1016/j.ultrasmedbio.2020.09.014
title:
  Portable pocket-sized ultrasound scanner for the evaluation of lung involvement in COVID-19 patients

abstract:
  Ultrasound imaging of the lung (LUS) and associated tissues has demonstrated clinical utility in COVID-19 patients. The aim of the present study was to evaluate the possibilities of a portable pocket-sized ultrasound scanner in the evaluation of lung involvement in patients with COVID-19 pneumonia. We conducted 437 paired readings in 34 LUS evaluations on hospitalized patients with COVID-19. The lung ultrasound scans were performed on the same day with a standard high-end ultrasound scanner (Venue GO™, GE Healthcare, Chicago, IL, USA) and a pocket-sized ultrasound scanner (Butterfly iQ, Butterfly Network Inc., Guilford, CT, USA). 14/34 scans were performed on severe, 11 on moderate and 9 on mild patients. No difference in days since onset of symptoms was observed between groups (23.29 ± 10.07, 22.91 ± 8.91, 28.56 ± 11.13 days, respectively, p=0.38). No significant differences were found between LUS scores obtained with the high-end and the portable pocket-sized ultrasound scanner. LUS scores in patients with mild respiratory impairment were significantly lower than in moderate and severe patients. Our study confirms the possibilities of portable pocket-sized ultrasound imaging of the lung in COVID-19 patients. Portable pocket-sized ultrasound scanners are cheap, easy to handle and equivalent to standard scanners for non-invasive assessment of severity and dynamic observation of lung lesions in COVID-19 patients.


id: cord-257566-56h2jmn9
title: COVID-19 as a Vascular Disease: Lesson Learned from Imaging and Blood Biomarkers
author: Zamboni, Paolo
date: 2020-06-29
url: https://www.ncbi.nlm.nih.gov/pubmed/32610564/
doi: 10.3390/diagnostics10070440
abstract:
  COVID-19, a disease initially thought to be prominently an interstitial pneumonia with varying degrees of severity, can be considered a vascular disease with regards to serious complications and causes of mortality. Quite recently, blood clots have emerged as the common factor unifying many of the symptoms initially attributed without an explanation to COVID-19. Cardiovascular biomarkers and particularly, D-dimer and troponin appear to be very powerful prognostic markers, signaling the need for earlier and more aggressive interventions and treatments in order to avoid and/or minimize arterial/venous thromboembolism and myocardial infarct. The ultrasound imaging patterns at both the lung and peripheral vascular level can also be very useful weapons that have the advantage of being able to monitor longitudinally the clinical picture, something that real-time PCR/nasopharyngeal swab is not able to do and that CT can only pursue with significant radiation exposure. A lesson learned in the early phase of the COVID-19 pandemic suggests quitting and starting again with targeted imaging and blood vascular biomarkers.


id: cord-261062-9zhe3ejy
title: Utility of Point-of-Care Lung Ultrasound for Clinical Classification of COVID-19
author: Zhu, Shu-Ting
date: 2020-09-21
url: https://api.elsevier.com/content/article/pii/S0301562920304282
doi: 10.1016/j.ultrasmedbio.2020.09.010
abstract:
  In this study, the utility of point-of-care lung ultrasound for the clinical classification of coronavirus disease (COVID-19) was prospectively assessed. Twenty-seven adult patients with COVID-19 underwent bedside lung ultrasonography (LUS) examinations three times within the first two weeks of admission to the isolation ward. We divided the 81 exams into three groups (i.e., moderate group, severe group, and critically ill group). Lung scores were calculated as the sum of points. A rank sum test and bivariate correlation analysis were carried out to determine the correlation between LUS on admission and the clinical classification of COVID-19. There were dramatic differences in LUS (p<0.001) among the three groups, and LUS scores (r=0.754) correlated positively with clinical severity (p<0.01). In addition, moderate, severe, and critically ill patients were more likely to have low (≤9), medium (9-15), and high scores (≥15), respectively. This study provides stratification criteria of LUS scores to assist in quantitatively evaluating COVID-19 patients.


id: cord-261328-prczsz9m
author: Yassa, Murat
date: 2020-10-02
url: https://www.ncbi.nlm.nih.gov/pubmed/33072428/
doi: 10.4274/tjod.galenos.2020.93902
title:
  How to perform and interpret the lung ultrasound by the obstetricians in pregnant women during the SARS-CoV-2 pandemic

abstract:
  OBJECTIVE: Evidence for the use of lung ultrasound scan (LUS) examinations in coronavirus 2019 pneumonia is rapidly growing. The safe and non-ionizing nature of LUS drew attention, particularly for pregnant women. This study aimed to contribute to the interpretation of LUS findings in pregnant women for the obstetricians. MATERIALS AND METHODS: LUS was performed to pregnant women suspected of or diagnosed as having Severe Acute Respiratory syndrome coronavirus-2 (SARS-CoV-2) in the first 24 hours of admission. Fourteen areas (3 posterior, 2 lateral, and 2 anterior) were scanned per patient for at least 10 seconds along the indicated anatomical landmarks. The scan was performed in supine, right-sided and left-sided positions, respectively. Each area was given a score between 0 and 3 according to the specific pattern. RESULTS: In this study, 21 still images and 21 videoclips that enabled dynamic and real-time evaluation were provided. Pleural line assessment, physiologic A-lines, pathologic B-lines, light beam pattern, white lung pattern, and specific patterns for quick recognition and evaluation are described. CONCLUSION: The potential advantages and limitations of LUS and its areas of use for obstetricians are discussed. LUS is a promising supplementary imaging tool during the SARS-CoV-2 pandemic. It is easy to perform and may be feasible in the hands of obstetricians after a brief didactic course. It may be a firstline imaging modality for pregnant women.


id: cord-262778-7vk6vcgk
author: Antúnez‐Montes, Omar Yassef
date: 2020-08-27
url: https://doi.org/10.1002/jum.15446
doi: 10.1002/jum.15446
abstract: nan
title:
  Proposal to Unify the Colorimetric Triage System With the Standardized Lung Ultrasound Score for COVID‐19


id: cord-276225-tv70aakj
title: Lung Ultrasound in Children with COVID-19: Preliminary Findings
author: Musolino, Anna Maria
date: 2020-05-03
url: https://www.sciencedirect.com/science/article/pii/S0301562920301988?v=s5
doi: 10.1016/j.ultrasmedbio.2020.04.026
abstract:
  Abstract— Recent evidence indicates the usefulness of lung ultrasound (LUS) in detecting coronavirus disease 19 (COVID-19) pneumonia. However, no data are available on the use of LUS in children with COVID-19 pneumonia. In this report, we describe LUS features of 10 consecutively admitted children with COVID-19 in two tertiary-level pediatric hospitals in Rome. LUS revealed signs of lung involvement during COVID-19 infection. In particular, vertical artifacts (70%), pleural irregularities (60%), areas of white lung (10%) and subpleural consolidations (10%) were the main findings in patients with COVID-19. No cases of pleural effusions were found. According to our experience, the routine use of LUS in the evaluation of children with suspected or confirmed COVID-19, when performed by clinicians with documented experience in LUS, was useful in diagnosing and monitoring pediatric COVID-19 pneumonia, reducing unnecessary radiation/sedation in children and exposure of health care workers to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).


id: cord-282198-ugmv9om1
title: Point-of-care Lung Ultrasound Is More Sensitive than Chest Radiograph for Evaluation of COVID-19
author: Pare, Joseph R.
date: 2020-06-19
url: https://www.ncbi.nlm.nih.gov/pubmed/32726240/
doi: 10.5811/westjem.2020.5.47743
abstract:
  INTRODUCTION: Current recommendations for diagnostic imaging for moderately to severely ill patients with suspected coronavirus disease 2019 (COVID-19) include chest radiograph (CXR). Our primary objective was to determine whether lung ultrasound (LUS) B-lines, when excluding patients with alternative etiologies for B-lines, are more sensitive for the associated diagnosis of COVID-19 than CXR. METHODS: This was a retrospective cohort study of all patients who presented to a single, academic emergency department in the United States between March 20 and April 6, 2020, and received LUS, CXR, and viral testing for COVID-19 as part of their diagnostic evaluation. The primary objective was to estimate the test characteristics of both LUS B-lines and CXR for the associated diagnosis of COVID-19. Our secondary objective was to evaluate the proportion of patients with COVID-19 that have secondary LUS findings of pleural abnormalities and subpleural consolidations. RESULTS: We identified 43 patients who underwent both LUS and CXR and were tested for COVID-19. Of these, 27/43 (63%) tested positive. LUS was more sensitive (88.9%, 95% confidence interval (CI), 71.1–97.0) for the associated diagnosis of COVID-19 than CXR (51.9%, 95% CI, 34.0–69.3; p = 0.013). LUS and CXR specificity were 56.3% (95% CI, 33.2–76.9) and 75.0% (95% CI, 50.0–90.3), respectively (p = 0.453). Secondary LUS findings of patients with COVID-19 demonstrated 21/27 (77.8%) had pleural abnormalities and 10/27 (37%) had subpleural consolidations. CONCLUSION: Among patients who underwent LUS and CXR, LUS was found to have a higher sensitivity than CXR for the evaluation of COVID-19. This data could have important implications as an aid in the diagnostic evaluation of COVID-19, particularly where viral testing is not available or restricted. If generalizable, future directions would include defining how to incorporate LUS into clinical management and its role in screening lower-risk populations.


id: cord-285369-ktg2b9jb
author: Mohamed, Mouhand F. H.
date: 2020-06-02
url: https://www.ncbi.nlm.nih.gov/pubmed/32500849/
doi: 10.4269/ajtmh.20-0371
title:
  Frequency of Abnormalities Detected by Point-of-Care Lung Ultrasound in Symptomatic COVID-19 Patients: Systematic Review and Meta-Analysis

abstract:
  The COVID-19 pandemic has resulted in significant morbidity, mortality, and strained healthcare systems worldwide. Thus, a search for modalities that can expedite and improve the diagnosis and management of this entity is underway. Recent data suggested the utility of lung ultrasound (LUS) in the diagnosis of COVID-19 by detecting an interstitial pattern (B-pattern). Hence, we aimed to pool the proportion of various reported lung abnormalities detected by LUS in symptomatic COVID-19 patients. We conducted a systematic review (PubMed, MEDLINE, and EMBASE until April 25, 2020) and a proportion meta-analysis. We included seven studies examining the role of LUS in 122 COVID-19 patients. The pooled proportion (PP) of B-pattern detected by lung ultrasound (US) was 0.97 (95% CI: 0.94–1.00 I(2) 0%, Q 4.6). The PP of finding pleural line abnormalities was 0.70 (95% CI: 0.13–1.00 I(2) 96%, Q 103.9), of pleural thickening was 0.54 (95% 0.11–0.95 I(2) 93%, Q 61.1), of subpleural or pulmonary consolidation was 0.39 (95% CI: 0.21–0.58 I(2) 72%, Q 17.8), and of pleural effusion was 0.14 (95% CI: 0.00–0.37 I(2) 93%, Q 27.3). Our meta-analysis revealed that almost all SARS-CoV-2–infected patients have abnormal lung US. The most common abnormality is interstitial involvement depicted as B-pattern. The finding from our review highlights the potential role of this modality in the triage, diagnosis, and follow-up of COVID-19 patients. A sizable diagnostic accuracy study comparing LUS, computed tomography scan, and COVID-19–specific tests is warranted to further test this finding and to delineate the diagnostic and prognostic yield of each of these modalities.


id: cord-286071-zb8o95yf
author: Nasrollahi, Vida
date: 2014-07-31
url: https://www.sciencedirect.com/science/article/pii/S0031942214001071
doi: 10.1016/j.phytochem.2014.03.004
title:
  The effect of drought stress on the expression of key genes involved in the biosynthesis of triterpenoid saponins in liquorice (Glycyrrhiza glabra)

abstract:
  Abstract Glycyrrhiza glabra is an important medicinal plant throughout the world. Glycyrrhizin is a triterpenoid that is among the most important secondary metabolites produced by liquorice. Drought stress is proposed to enhance the levels of secondary metabolites. In this study, the effect of drought stress on the expression of important genes involved in the glycyrrhizin biosynthetic pathway was examined. Drought stress at the seedling stage was applied to 8-day-old plants using polyethylene glycol. Subsequently, the samples were collected 0, 4, 8 or 24h post-treatment. At the adult plant stage, 10-month-old plants were subjected to drought stress by discontinuing irrigation. Subsequently, samples were collected at 2, 16 and 28days after drought imposition (S2d, S16d and S28d, respectively). We performed semi-quantitative RT-PCR assays to evaluate the gene expression levels of sequalene synthase (SQS), β-amyrin synthase (bAS), lupeol synthase (LUS) and cycloartenol synthase (CAS) during stress. Finally, the glycyrrhizin content of stolons was determined via HPLC. The results revealed that due to osmotic stress, the gene expression levels of SQS and bAS were increased, whereas those of CAS were relatively unchanged at the seedling stage. At the adult plant stage, the expression levels of SQS and bAS were increased under drought stress conditions, whereas the gene expression level of CAS remained relatively constant. The glycyrrhizin content in stolons was increased only under severe drought stress conditions (S28d). Our results indicate that application of controlled drought stress up-regulates the expression of key genes involved in the biosynthesis of triterpenoid saponins and directly enhances the production of secondary metabolites, including glycyrrhizin, in liquorice plants.


id: cord-292341-uo54ghf3
title: Clinical Features and Chest Imaging as Predictors of Intensity of Care in Patients with COVID-19
author: Cocconcelli, Elisabetta
date: 2020-09-16
url: https://www.ncbi.nlm.nih.gov/pubmed/32947904/
doi: 10.3390/jcm9092990
abstract:
  Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic with lung disease representing the main cause of morbidity and mortality. Conventional chest-X ray (CXR) and ultrasound (US) are valuable instruments to assess the extent of lung involvement. We investigated the relationship between CXR scores on admission and the level of medical care required in patients with COVID-19. Further, we assessed the CXR-US correlation to explore the role of ultrasound in monitoring the course of COVID-19 pneumonia. Clinical features and CXR scores were obtained at admission and correlated with the level of intensity of care required [high- (HIMC) versus low-intensity medical care (LIMC)]. In a subgroup of patients, US findings were correlated with clinical and radiographic parameters. On hospital admission, CXR global score was higher in HIMCs compared to LIMC. Smoking history, pO(2) on admission, cardiovascular and oncologic diseases were independent predictors of HIMC. The US score was positively correlated with FiO(2) while the correlation with CXR global score only trended towards significance. Our study identifies clinical and radiographic features that strongly correlate with higher levels of medical care. The role of lung ultrasound in this setting remains undetermined and needs to be explored in larger prospective studies.


id: cord-300013-6m1f4q5r
author: Brahier, Thomas
date: 2020-09-17
url: https://www.ncbi.nlm.nih.gov/pubmed/32940646/
doi: 10.1093/cid/ciaa1408
title:
  Lung ultrasonography for risk stratification in patients with COVID-19: a prospective observational cohort study

abstract:
  BACKGROUND: Point-of-care lung ultrasound (LUS) is a promising pragmatic risk stratification tool in COVID-19. This study describes and compares LUS characteristics between patients with different clinical outcomes METHODS: Prospective observational study of PCR-confirmed COVID-19 adults with symptoms of lower respiratory tract infection in the emergency department (ED) of Lausanne University Hospital. A trained physician recorded LUS images using a standardized protocol. Two experts reviewed images blinded to patient outcome. We describe and compare early LUS findings (acquired within 24hours of presentation to the ED) between patient groups based on their outcome at 7 days after inclusion: 1) outpatients, 2) hospitalised and 3) intubated/death. Normalized LUS score was used to discriminate between groups RESULTS: Between March 6 and April 3 2020, we included 80 patients (17 outpatients, 42 hospitalized and 21 intubated/dead). 73 patients (91%) had abnormal LUS (70% outpatients, 95% hospitalised and 100% intubated/death; p=0.003). The proportion of involved zones was lower in outpatients compared with other groups (median 30% [IQR 0-40%], 44% [31-70%] and 70% [50-88%], p<0.001). Predominant abnormal patterns were bilateral and multifocal spread thickening of the pleura with pleural line irregularities (70%), confluent B lines (60%) and pathologic B lines (50%). Posterior inferior zones were more often affected. Median normalized LUS score had a good level of discrimination between outpatients and others with area under the ROC of 0.80 (95% CI 0.68-0.92) CONCLUSIONS: Systematic LUS has potential as a reliable, cheap and easy-to-use triage tool for the early risk stratification in COVID-19 patients presenting in EDs


id: cord-309194-jtouafgd
author: Lu, Xiao
date: 2020-09-03
url: https://www.ncbi.nlm.nih.gov/pubmed/32881950/
doi: 10.1371/journal.pone.0238679
title:
  Lung ultrasound score in establishing the timing of intubation in COVID-19 interstitial pneumonia: A preliminary retrospective observational study

abstract:
  PURPOSE: To investigate the role of lung ultrasound score (LUS) in assessing intubation timing for patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. MATERIALS AND METHODS: Seventy-two patients with critical coronavirus disease 2019 (COVID-19) were admitted to a makeshift intensive care unit (ICU). All patients underwent bedside lung ultrasonography one to two times per day. The patients were either intubated, treated with noninvasive ventilation (NIV), or given high-flow nasal cannula (HFNC) after a discussion with the multidisciplinary group after their conditions worsened. Bedside lung ultrasound was performed daily after intubation, and patients received mechanical ventilation. Lung ultrasound was performed on days 1, 2, 3, 5, and 7 after patients were admitted to the ICU; if the patient was intubated, LUS determination was performed before intubation within 24 h (T1) and on days 1, 2, 5, and 7 after intubation (T2, T3, T4, and T5, respectively).The goal of this study was to evaluate the severity of lung aeration loss in intubated and non-intubated patients with SARS-CoV-2 pneumonia by ultrasound at different time points within one week. RESULTS: A total of 16 patients were included in this study, including nine who were intubated and mechanically ventilated and seven patients without intubation. The number of elderly individuals in the intubated group was higher than in the non-intubated group (P < 0.05). In addition, there were more male than female patients in both groups. Patient characteristics (BMI, SOFA, and PaO(2)/FiO(2) value) were similar between the two groups (P > 0.05). The 28-day mortality rate of intubated patients was higher than that of non-intubated patients; six patients in the intubated group and two patients in the non-intubated group died. Nine intubated patients showed changes in LUS within seven days (n = 9). The mean LUS within 24 h before intubation was 12.8 ± 1.3. LUS was significantly higher on T1 than on T5 (P <0.05), and did not significantly differ from T1 to T4. Comparing LUS between intubated and non-intubated patients on T1 showed that the LUS of intubated patients was significantly higher than that of non-intubated patients (P <0.05). Between the two patient groups, oxygenation index was 140.1 ± 7.7 vs. 137.8 ± 5.9 on T1, and the respiratory rate of the two groups was 26 ± 5 vs. 28 ± 4 breaths/min. Neither oxygenation index nor RR significantly differed between the two groups. CONCLUSION: LUS may be an effective tool for assessing intubation timing in critically ill patients with Covid-19 interstitial pneumonia.


id: cord-309660-s8neq5x4
author: Arntfield, R.
date: 2020-10-15
txt: ./txt/cord-309660-s8neq5x4.txt
cache: ./cache/cord-309660-s8neq5x4.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.10.13.20212258
doi: 10.1101/2020.10.13.20212258
summary:
  In this study, we trained a neural network using LUS images of B lines from 3 different etiologies (hydrostatic pulmonary edema (HPE), ARDS and COVID-19). 16 The goal of this study was to determine if a deep neural network could distinguish between the B line profiles of 3 different disease profiles, namely 1) hydrostatic pulmonary edema (HPE); 2) non-COVID ARDS (NCOVID) causes; and 3) COVID-19 ARDS (COVID). On this independent data, the model demonstrated a strong ability to distinguish between the 3 relevant causes of B lines with AUCs at the encounter level of 1.0 (COVID), 0.934 (NCOVID), and 1.0 (HPE), producing an overall AUC of 0.978 for the classifier. In this study, a deep learning model was successfully trained to distinguish the underlying pathology in similar point-of-care lung ultrasound images containing B lines.

title:
  Development of a deep learning classifier to accurately distinguish COVID-19 from look-a-like pathology on lung ultrasound

abstract:
  Objectives Lung ultrasound (LUS) is a portable, low cost respiratory imaging tool but is challenged by user dependence and lack of diagnostic specificity. It is unknown whether the advantages of LUS implementation could be paired with deep learning techniques to match or exceed human-level, diagnostic specificity among similar appearing, pathological LUS images. Design A convolutional neural network was trained on LUS images with B lines of different etiologies. CNN diagnostic performance, as validated using a 10% data holdback set was compared to surveyed LUS-competent physicians. Setting Two tertiary Canadian hospitals. Participants 600 LUS videos (121,381 frames) of B lines from 243 distinct patients with either 1) COVID-19, Non-COVID acute respiratory distress syndrome (NCOVID) and 3) Hydrostatic pulmonary edema (HPE). Results The trained CNN performance on the independent dataset showed an ability to discriminate between COVID (AUC 1.0), NCOVID (AUC 0.934) and HPE (AUC 1.0) pathologies. This was significantly better than physician ability (AUCs of 0.697, 0.704, 0.967 for the COVID, NCOVID and HPE classes, respectively), p < 0.01. Conclusions A deep learning model can distinguish similar appearing LUS pathology, including COVID-19, that cannot be distinguished by humans. The performance gap between humans and the model suggests that subvisible biomarkers within ultrasound images could exist and multi-center research is merited.


id: cord-320171-ifbpz42a
author: Cho, Young-Jae
date: 2020-07-01
txt: ./txt/cord-320171-ifbpz42a.txt
cache: ./cache/cord-320171-ifbpz42a.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3904/kjim.2020.180
doi: 10.3904/kjim.2020.180
summary:
  We sought to determine the utility of lung ultrasound for early detection of pneumonia and for assessment of respiratory failure among patients with coronavirus disease 2019 (COVID-19). CONCLUSIONS: Lung ultrasound is feasible and useful as a rapid, sensitive, and affordable point-of-care screening tool to detect pneumonia and assess the severity of respiratory failure in patients hospitalized with COVID-19. In South Korea, there have been multiple confirmed cases related to local outbreak clusters, but there are no rapid, sensitive, affordable screening tools available to assess the presence of pneumonia, disease severity, or risk of respiratory fail-The Korean Journal of Internal Medicine. LUS performed on Day 4 showed a worsening of her pneumonia, with the lung aeration score of 5 points (Supplementary Fig. 5C ). In conclusion, LUS was feasible and useful for a rapid, sensitive, affordable point-of-care screening tool to detect pneumonia without radiation hazard and suggest the severity of respiratory failure for COVID-19 patients.

title:
  Lung ultrasound for early diagnosis and severity assessment of pneumonia in patients with coronavirus disease 2019

abstract:
  BACKGROUND/AIMS: Current evidence supports lung ultrasound as a point-of-care alternative diagnostic tool for various respiratory diseases. We sought to determine the utility of lung ultrasound for early detection of pneumonia and for assessment of respiratory failure among patients with coronavirus disease 2019 (COVID-19). METHODS: Six patients with confirmed COVID-19 by reverse transcription-polymerase chain reaction were enrolled. All had undergone chest X-ray and chest computed tomography (CT) on the day of admission and underwent multiple point-of-care lung ultrasound scans over the course of their hospitalization. RESULTS: Lung ultrasound detected early abnormal findings of representative B-lines in a patient with a normal chest X-ray, corresponding to ground-glass opacities on the chest CT scan. The ultrasound findings improved as her clinical condition improved and her viral load decreased. In another minimally symptomatic patient without significant chest X-ray findings, the ultrasound showed B-lines, an early sign of pneumonia before abnormalities were detected on the chest CT scan. In two critically ill patients, ultrasound was performed to assess for evaluation of disease severity. In both patients, the clinicians conducted emergency rapid sequence intubation based on the ultrasound findings without awaiting the laboratory results and radiological reports. In two children, ultrasound was used to assess the improvement in their pneumonia, thus avoiding further imaging tests such as chest CT. CONCLUSIONS: Lung ultrasound is feasible and useful as a rapid, sensitive, and affordable point-of-care screening tool to detect pneumonia and assess the severity of respiratory failure in patients hospitalized with COVID-19.


id: cord-326051-p9017jx8
author: Lopes, Agnaldo José
date: 2020-09-30
url: https://doi.org/10.1002/jum.15521
doi: 10.1002/jum.15521
title:
  Comparison Between Lung Ultrasound and Computed Tomographic Findings in Patients With COVID‐19 Pneumonia

abstract:
  OBJECTIVES: The aim of this study was to describe findings from lung ultrasound (LUS) and computed tomography (CT) in health professionals with coronavirus disease 2019 pneumonia and to evaluate the associations of the findings of both tests. METHODS: This cross‐sectional observational study evaluated 45 health professionals who were initially seen in screening tents and had a diagnosis of coronavirus disease 2019 as confirmed by a reverse transcription polymerase chain reaction and lung involvement diagnosed by LUS. Subsequently, these individuals were admitted to the hospital, where chest CT was performed. Aeration scores were obtained for the LUS examinations based on the following findings: more than 2 B‐lines, coalescent B‐lines, and subpleural consolidations. A subjective assessment of the extent of lung disease on CT was performed on the basis of the percentage of lung parenchyma involvement as follows: 25% or less, 25% to 50%, and greater than 50%. RESULTS: Regarding LUS signs, more than 2 B‐lines, coalescent B‐lines, and subpleural consolidations were present in 73.3%, 68.2%, and 24.4% of cases, respectively. The main findings on CT were ground glass opacities, a crazy‐paving pattern, and consolidations (66.7%, 20%, and 20% of cases); 17.8% of cases had examinations without abnormalities. Patients with more than 2 B‐lines on LUS had more ground glass opacity areas on CT (P = .0007), whereas patients with subpleural consolidations on LUS had more consolidations on CT (P < .0001). In addition, patients with higher LUS aeration scores had more extensive disease on CT (P < .0001). CONCLUSIONS: Lung ultrasound can detect lung injury even in the presence of normal CT results. There are associations between the abnormalities detected by both methods, and a relationship also exists between LUS aeration scores and the disease extent on CT.


id: cord-334495-7y1la856
title: Heart and Lung Multimodality Imaging in COVID-19
author: Agricola, Eustachio
date: 2020-06-24
txt: ./txt/cord-334495-7y1la856.txt
cache: ./cache/cord-334495-7y1la856.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1936878X20304770
doi: 10.1016/j.jcmg.2020.05.017
summary:
  From a clinical point of view, cardiac involvement during COVID-19 may present a wide spectrum of severity ranging from subclinical myocardial injury to well-defined clinical entities (myocarditis, myocardial infarction, pulmonary embolism and heart failure), whose incidence and prognostic implications are currently largely unknown due to a significant lack of imaging data. The use of integrated heart and lung multimodality imaging plays a central role in different clinical settings and is essential in diagnosis, risk stratification and management of COVID-19 patients. In this context, the use of multiple diagnostic imaging techniques may apply to both heart and lung to provide an integrated assessment of cardiac and pulmonary function and to refine diagnosis, risk stratification and management of COVID-19 patients. patients not requiring ICU, when clinical presentation and biomarker alterations suggest acute-onset myocardial inflammation, if the diagnosis is likely to impact on management, CMR may be considered to confirm acute myocarditis, after exclusion of alternative relevant clinical conditions, including ACS and HF, by means of other rapidly available imaging modalities (i.e. cardiac CT scan or TTE).

abstract:
  Abstract SARS-CoV-2 outbreak has rapidly reached a pandemic proportion and has become a major threaten to global health. Although the predominant clinical feature of COVID-19 is an acute respiratory syndrome of varying severity, ranging from mild symptomatic interstitial pneumonia to acute respiratory distress syndrome, the cardiovascular system can be involved with several facets. As many as 40% hospitalized patients presenting with COVID-19 have pre-existing history of cardiovascular disease and current estimates report a proportion of myocardial injury in COVID-19 patients ranging up to 12%. Multiple pathways have been advocated to explain this finding and the related clinical scenarios, encompassing local and systemic inflammatory response and oxygen supply-demand imbalance. From a clinical point of view, cardiac involvement during COVID-19 may present a wide spectrum of severity ranging from subclinical myocardial injury to well-defined clinical entities (myocarditis, myocardial infarction, pulmonary embolism and heart failure), whose incidence and prognostic implications are currently largely unknown due to a significant lack of imaging data. The use of integrated heart and lung multimodality imaging plays a central role in different clinical settings and is essential in diagnosis, risk stratification and management of COVID-19 patients. Aim of this review is to summarize imaging-oriented pathophysiological mechanisms of lung and cardiac involvement in COVID-19 and to provide a guide for an integrated imaging assessment in these patients.


id: cord-338005-kbkvk94k
author: Deng, Qing
date: 2020-07-14
url: https://www.ncbi.nlm.nih.gov/pubmed/32713715/
doi: 10.1016/j.acra.2020.07.002
title:
  Semiquantitative lung ultrasound scores in the evaluation and follow-up of critically ill patients with COVID-19: a single-center study

abstract:
  RATIONALE AND OBJECTIVES: Chest CT is not suitable for critically ill patients with COVID-19 and lung ultrasound (LUS) may play an important role for these patients. In this study, we summarized the findings of LUS and explore the value of semiquantitative LUS scores in evaluation and follow-up of COVID-19 pneumonia. MATERIALS AND METHODS: Retrospectively studied the LUS and chest CT imaging of 128 critically ill patients with COVID-19. The imaging data were reviewed to acquire the LUS and CT scores. The correlation between LUS scores and CT scores were made to evaluate the accuracy of LUS. A cut-off point of LUS score was calculated to distinguish critical-type patients from severe-type patients. LUS follow-up of 72 patients were compared with the gold standard chest CT. RESULTS: The most common LUS features of COVID-19 pneumonia were crowded or coalescent B-lines with multifocal small consolidations in multi-zone. The mean LUS score was 8.1 points in severe-type patients and 15.7 points in critical-type patients (P<0.05). The correlation between LUS scores and CT scores was high (r=0.891, p<0.01) and it was higher in critical-type patients than that in severe-type patients. The LUS score higher than 10.5 points had a 97.4% sensitivity and 75.0% specificity to distinguish critical-type patients. The consistency of LUS and chest CT in follow-up was 0.596, with higher consistency in diagnosis of lesion progression (Kappa values was 0.774). CONCLUSION: Our scoring system provides a more quantitative use of LUS findings and accurate evaluation of lung damage for critically ill patients with COVID-19.


id: cord-341627-21m8rdhy
title: Lung ultrasound in the diagnosis of COVID-19 infection - A case series and review of the literature
author: Buda, Natalia
date: 2020-06-25
url: https://doi.org/10.1016/j.advms.2020.06.005
doi: 10.1016/j.advms.2020.06.005
abstract:
  COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and spreading worldwide has become a serious challenge for the entire health care system as regards infection prevention, rapid diagnosis, and treatment. Lung ultrasound (LUS) is a dynamically developing diagnostic method used in intensive care, cardiology and nephrology, it can also be helpful in diagnosing and monitoring pneumonia. Interstitial pneumonia appears to be the most common clinical manifestation of coronavirus infection. We present 4 case reports of COVID-19 involving the lungs, in which transthoracic lung ultrasound was successfully utilized as a constituent of bedside diagnostics and a review of the literature concerning potential use of LUS in COVID-19 diagnostics. The possibility to perform this examination repeatedly, its non-invasiveness and high sensitivity make it an important element of care provided for patients with viral pneumonia.


id: cord-344117-lr6roxej
author: Vieira, Ana Luisa Silveira
date: 2020-06-03
txt: ./txt/cord-344117-lr6roxej.txt
cache: ./cache/cord-344117-lr6roxej.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1186/s13089-020-00177-4
doi: 10.1186/s13089-020-00177-4
summary:
  Reports from health services around the world have indicated that patients with diabetes mellitus and hypertension, two of the main causes of ESRD worldwide, and also advanced age and cardiovascular complications, two frequent accompanying conditions in dialysis patients, are more susceptible to SARS-CoV-2 infection and more prone to develop severe COVID-19 pneumonia, eventually requiring intensive care treatment [2, 6, 7] . The typical patterns detected by LUS in patients with COVID-19 pneumonia are characterized by B-lines in different forms, both separated and coalescent, an irregular and/or fragmented pleural line, peripheral small consolidations, and large consolidations with dynamic air bronchograms [3] (Fig. 7) (Additional file 5). If the B-lines pattern that can be observed by LUS in dialytic patients does not fully respect the typical characteristics of a COVID-19 pneumonia and cannot allow a definitive conclusion, we suggest to extend the ultrasound scan to the heart and the inferior vena cava (IVC).

title:
  Role of point-of-care ultrasound during the COVID-19 pandemic: our recommendations in the management of dialytic patients

abstract:
  COVID-19 is a viral disease due to the infection of the novel Corona virus SARS-CoV-2, that has rapidly spread in many countries until the World Health Organization declared the pandemic from March 11, 2020. Elderly patients and those affected by hypertension, diabetes mellitus, and chronic pulmonary and cardiovascular conditions are more susceptible to present more severe forms of COVID-19. These conditions are often represented in dialytic renal end-stage patients. Moreover, dialysis patients are more vulnerable to infection due to suppression of the immune system. Growing evidences, although still supported by few publications, are showing the potential utility of ultrasound in patients with COVID-19. In this review, we share our experience in using point-of-care ultrasound, particularly lung ultrasound, to indicate the probability of COVID-19 in patients with end-stage renal disease treated by hemodialysis. We also propose recommendations for the application of lung ultrasound, focused echocardiography and inferior vena cava ultrasound in the management of patients in hemodialysis.


id: cord-347631-78h9w2ty
author: Yun, Debo
date: 2020-10-10
url: https://doi.org/10.1177/2050313x20958915
doi: 10.1177/2050313x20958915
title:
  Use of lung ultrasound for diagnosis and monitoring of coronavirus disease 2019 pneumonia: A case report

abstract:
  Knowledge of lung ultrasound characteristics of coronavirus disease 2019 pneumonia might be useful for early diagnosis and clinical monitoring of patients, and lung ultrasound can help to control the spread of infection in healthcare settings. In this case report, a 36-year-old man with severe acute respiratory syndrome coronavirus 2 infection was diagnosed by reverse transcription-polymerase chain reaction testing of a nasopharyngeal swab. The lung ultrasound findings for this patient were the interstitial-alveolar damage showing bilateral, diffuse pleural line abnormalities, subpleural consolidations, white lung areas and thick, irregular vertical artifacts. When the patient recovered from the severe acute respiratory syndrome coronavirus 2 infection, lung ultrasound images showed a normal pleural line with A-lines regularly reverberating. Performing lung ultrasound at the bedside minimizes the need to move the patient, thus reducing the risk of spreading infection among healthcare staff. Lung ultrasound is useful for early diagnosis and evaluation of the severity of coronavirus disease 2019 pneumonia and for monitoring its progress over the course of the disease.


id: cord-349641-4g4nue5s
author: Kirkpatrick, Andrew W.
date: 2020-07-08
url: https://www.ncbi.nlm.nih.gov/pubmed/32639037/
doi: 10.1002/jum.15390
abstract: nan
title:
  Re: “Proposal for International Standardization of the Use of Lung Ultrasound for Patients With COVID‐19: A Simple, Quantitative, Reproducible Method”—Could Telementoring of Lung Ultrasound Reduce Health Care Provider Risks, Especially for Paucisymptomatic Home‐Isolating Patients?


id: cord-354204-23xkug85
author: Smargiassi, Andrea
date: 2020-07-07
url: https://doi.org/10.1007/s40477-020-00501-7
doi: 10.1007/s40477-020-00501-7
title:
  Lung ultrasonography for early management of patients with respiratory symptoms during COVID-19 pandemic

abstract:
  COVID-19 pandemic is representing a serious challenge to worldwide public health. Lung Ultrasonography (LUS) has been signaled as a potential useful tool in this pandemic contest either to intercept viral pneumonia or to foster alternative paths. LUS could be useful in determining early lung involvement suggestive or not of COVID-19 pneumonia and potentially plays a role in managing decisions for hospitalization in isolation or admission in general ward. In order to face pandemic, in a period in which a large number of emergency room accesses with suspicious symptoms are expected, physicians need a standardized ultrasonographic approach, fast educational processes in order to be able to recognize both suggestive and not suggestive echographic signs and shared algorithms for LUS role in early management of patients.


id: cord-354411-4emzxu09
title: Lung Ultrasound in COVID-19 Pneumonia: Correlations with Chest CT on Hospital admission
author: Nouvenne, Antonio
date: 2020-06-22
url: https://doi.org/10.1159/000509223
doi: 10.1159/000509223
abstract:
  BACKGROUND: Lung ultrasound (LUS) is an accurate, safe, and cheap tool assisting in the diagnosis of several acute respiratory diseases. The diagnostic value of LUS in the workup of coronavirus disease-19 (COVID-19) in the hospital setting is still uncertain. OBJECTIVES: The aim of this observational study was to explore correlations of the LUS appearance of COVID-19-related pneumonia with CT findings. METHODS: Twenty-six patients (14 males, age 64 ± 16 years) urgently hospitalized for COVID-19 pneumonia, who underwent chest CT and bedside LUS on the day of admission, were enrolled in this observational study. CT images were reviewed by expert chest radiologists, who calculated a visual CT score based on extension and distribution of ground-glass opacities and consolidations. LUS was performed by clinicians with certified competency in thoracic ultrasonography, blind to CT findings, following a systematic approach recommended by ultrasound guidelines. LUS score was calculated according to presence, distribution, and severity of abnormalities. RESULTS: All participants had CT findings suggestive of bilateral COVID-19 pneumonia, with an average visual scoring of 43 ± 24%. LUS identified 4 different possible ­abnormalities, with bilateral distribution (average LUS score 15 ± 5): focal areas of nonconfluent B lines, diffuse confluent B lines, small subpleural microconsolidations with pleural line irregularities, and large parenchymal consolidations with air bronchograms. LUS score was significantly correlated with CT visual scoring (r = 0.65, p < 0.001) and oxygen saturation in room air (r = −0.66, p < 0.001). CONCLUSION: When integrated with clinical data, LUS could represent a valid diagnostic aid in patients with suspect COVID-19 pneumonia, which reflects CT findings.


