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Lung ultrasound predicts clinical course but not outcome in COVID-19 ICU patients: a retrospective single-center analysis

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Title: Lung ultrasound predicts clinical course but not outcome in COVID-19 ICU patients: a retrospective single-center analysis
Authors: Stephanie-Susanne Stecher, Sofia Anton, Alessia Fraccaroli, Jeremias Götschke, Hans Joachim Stemmler, Michaela Barnikel
Source: BMC Anesthesiol
BMC Anesthesiology, Vol 21, Iss 1, Pp 1-8 (2021)
BMC anesthesiology, 21(1):178
Publisher Information: Springer Science and Business Media LLC, 2021.
Publication Year: 2021
Subject Terms: Male, Critical Care, 03 medical and health sciences, 0302 clinical medicine, Clinical course, COVID-19, Critical care, Deterioration, Aged [MeSH], Germany/epidemiology [MeSH], COVID-19/pathology [MeSH], Critical Care/methods [MeSH], Male [MeSH], COVID-19/epidemiology [MeSH], SARS-CoV-2 [MeSH], Research Article, COVID-19/diagnosis [MeSH], Female [MeSH], Outcome, Ultrasonography/methods [MeSH], Lung ultrasound, Humans [MeSH], Predictive Value of Tests [MeSH], Retrospective Studies [MeSH], Lung ultrasound score, Middle Aged [MeSH], Point-of-Care Testing [MeSH], Lung/diagnostic imaging [MeSH], Prognosis [MeSH], Anesthesiology, Predictive Value of Tests, Germany, Humans, RD78.3-87.3, Lung, Aged, Retrospective Studies, Ultrasonography, 2. Zero hunger, SARS-CoV-2, Middle Aged, Prognosis, 3. Good health, Point-of-Care Testing, Female
Description: Background Point-of-care lung ultrasound (LU) is an established tool in the first assessment of patients with coronavirus disease (COVID-19). Purpose of this study was to evaluate the value of lung ultrasound in COVID-19 intensive care unit (ICU) patients in predicting clinical course and outcome. Methods We analyzed lung ultrasound score (LUS) of all COVID-19 patients admitted from March 2020 to December 2020 to the Internal Intensive Care Unit, Ludwig-Maximilians-University (LMU) of Munich. LU was performed according to a standardized protocol at ICU admission and in case of clinical deterioration with the need for intubation. A normal lung scores 0 points, the worst LUS has 24 points. Patients were stratified in a low (0–12 points) and a high (13–24 points) lung ultrasound score group. Results The study included 42 patients, 69% of them male. The most common comorbidities were hypertension (81%) and obesity (57%). The values of pH (7.42 ± 0.09 vs 7.35 ± 0.1; p = 0.047) and paO2 (107 [80–130] vs 80 [66–93] mmHg; p = 0.034) were significantly reduced in patients of the high LUS group. Furthermore, the duration of ventilation (12.5 [8.3–25] vs 36.5 [9.8–70] days; p = 0.029) was significantly prolonged in this group. Patchy subpleural thickening (n = 38; 90.5%) and subpleural consolidations (n = 23; 54.8%) were present in most patients. Pleural effusion was rare (n = 4; 9.5%). The median total LUS was 11.9 ± 3.9 points. In case of clinical deterioration with the need for intubation, LUS worsened significantly compared to baseline LU. Twelve patients died during the ICU stay (29%). There was no difference in survival in both LUS groups (75% vs 66.7%, p = 0.559). Conclusions LU can be a useful monitoring tool to predict clinical course but not outcome of COVID-19 ICU patients and can early recognize possible deteriorations.
Document Type: Article
Conference object
Other literature type
Language: English
ISSN: 1471-2253
DOI: 10.1186/s12871-021-01396-5
Access URL: https://bmcanesthesiol.biomedcentral.com/track/pdf/10.1186/s12871-021-01396-5
https://pubmed.ncbi.nlm.nih.gov/34182946
https://doaj.org/article/51cd210b392d4f0db4f606eb8cfc59b6
https://link.springer.com/article/10.1186/s12871-021-01396-5
https://search.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/en/covidwho-1286811
https://pesquisa.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/pt/covidwho-1286811
https://bmcanesthesiol.biomedcentral.com/articles/10.1186/s12871-021-01396-5
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8236568/
https://link.springer.com/content/pdf/10.1186/s12871-021-01396-5.pdf
https://repository.publisso.de/resource/frl:6465195
https://epub.ub.uni-muenchen.de/90781/
Rights: CC BY
Accession Number: edsair.doi.dedup.....5ceeebf9051cfd842b776dbdfb861796
Database: OpenAIRE
Description
Abstract:Background Point-of-care lung ultrasound (LU) is an established tool in the first assessment of patients with coronavirus disease (COVID-19). Purpose of this study was to evaluate the value of lung ultrasound in COVID-19 intensive care unit (ICU) patients in predicting clinical course and outcome. Methods We analyzed lung ultrasound score (LUS) of all COVID-19 patients admitted from March 2020 to December 2020 to the Internal Intensive Care Unit, Ludwig-Maximilians-University (LMU) of Munich. LU was performed according to a standardized protocol at ICU admission and in case of clinical deterioration with the need for intubation. A normal lung scores 0 points, the worst LUS has 24 points. Patients were stratified in a low (0–12 points) and a high (13–24 points) lung ultrasound score group. Results The study included 42 patients, 69% of them male. The most common comorbidities were hypertension (81%) and obesity (57%). The values of pH (7.42 ± 0.09 vs 7.35 ± 0.1; p = 0.047) and paO2 (107 [80–130] vs 80 [66–93] mmHg; p = 0.034) were significantly reduced in patients of the high LUS group. Furthermore, the duration of ventilation (12.5 [8.3–25] vs 36.5 [9.8–70] days; p = 0.029) was significantly prolonged in this group. Patchy subpleural thickening (n = 38; 90.5%) and subpleural consolidations (n = 23; 54.8%) were present in most patients. Pleural effusion was rare (n = 4; 9.5%). The median total LUS was 11.9 ± 3.9 points. In case of clinical deterioration with the need for intubation, LUS worsened significantly compared to baseline LU. Twelve patients died during the ICU stay (29%). There was no difference in survival in both LUS groups (75% vs 66.7%, p = 0.559). Conclusions LU can be a useful monitoring tool to predict clinical course but not outcome of COVID-19 ICU patients and can early recognize possible deteriorations.
ISSN:14712253
DOI:10.1186/s12871-021-01396-5